Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
UnitedHealthcare June 2026 Bulletin: Five Lab Testing Policies Start September 1
UnitedHealthcare's June 2026 reimbursement bulletin, posted June 1, introduces five commercial lab testing policies effective September 1, 2026: allergen testing, hepatic fibrosis, chemotherapy assays, testosterone and vitamin B12. What each limits, the codes involved and what to check now.
How to Run an E/M Distribution Analysis by Provider and Read the Bell Curve
An E/M distribution analysis shows how each provider spreads office visits across 99212 to 99215 and how that compares to peers. Here is how to pull the report, what a normal curve looks like after the 2021 rules, and what an outlier pattern usually means when we open the notes.
CMS Publishes the Medicaid Work Requirement Rule: What Practices Should Prepare
On June 1, 2026 CMS released the interim final rule implementing Medicaid community engagement requirements for expansion adults, due in every affected state by January 1, 2027. What the rule requires, who is exempt, how coverage will be lost, and what a practice's front desk and billing team should change first.
NCCI Edits for July 1, 2026 Are Posted: 2,199 New Pairs and How to Load Them
CMS posted the July 1, 2026 NCCI procedure-to-procedure files on June 1. Version 322 adds 2,199 edit pairs and deletes 708. Here is how we read the quarterly change files, load them into the scrubber, and find the pairs that will hit your own top codes before the first July claim run.
How to Run a Weekly Billing Meeting: Six Numbers, Who Attends, What It Decides
Most practices find out about a billing problem when the bank balance drops. A weekly billing meeting finds it four to six weeks earlier. We give the 30-minute agenda built on six numbers, who is in the room, the report each number comes from, a worked example and the three decisions every meeting should end with.
HIPAA Multifactor Authentication and Password Managers: A 30-Day Practice Plan
The front desk shares one EHR login, the payer portal password is on a sticky note and nobody has MFA on email. We explain what HIPAA multifactor authentication rules require today and what is proposed, why shared logins fail the Security Rule, and how to roll out a password manager and MFA in four weeks.
Coding Hypertension With Heart and Kidney Disease: I10 to I13 and Sequencing
Hypertension is the most common diagnosis in primary care and one of the most often miscoded once the heart or kidneys are involved. We explain coding hypertension with heart and kidney disease: when I10 is wrong, how I11, I12 and I13 work, the presumed causal link and the N18 and I50 codes that must follow.
UnitedHealthcare to Drop Prior Authorization for About 30 Percent of Services
On May 5, 2026 UnitedHealthcare said it will eliminate prior authorization for roughly 30 percent of the services that still require it, by the end of the year. Three weeks on, here is what the announcement does and does not say, what to check when the code lists post, and how to avoid the denials that follow.
Medication Reconciliation Workflow for PCMH: Who, When and How to Document
Every practice says it reconciles medications; few can show a report proving it. We lay out a medication reconciliation workflow that satisfies NCQA PCMH criteria KM 14 and KM 15: who collects, who reconciles, who signs, the triggers that start it, what the note must contain and the numbers to report each month.
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