Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
MIPS Payment Adjustments on 2026 Medicare Remits: CARC 144, 237 and Remark N807
Since January 1, every Medicare Part B remit carries the result of your 2024 MIPS score, as a small increase or a cut of up to nine percent. We explain how the 2026 MIPS payment adjustment appears on the remit, how to verify it against your final score, and what to do if the numbers disagree.
2025 Healthcare Data Breaches: 710 Large Breaches and What Practices Should Do
The 2025 numbers are in: 710 breaches of 500 or more records reported to OCR, 61.5 million people affected, and providers accounting for more than half of the incidents. We read the year-end report for what it says about practices your size, and list the controls that would have stopped most of it.
Medical Billing Terms Every Physician Should Know: A Working Glossary
Physicians sign off on billing reports full of words they were never taught. This glossary covers the medical billing terms every physician should know, grouped by where they appear in the revenue cycle, with the number to watch next to each and a note on how each term gets misused.
Patient Registration Errors That Cause Claim Denials: Ten Fields to Get Right
Most denials are born at check-in, not in the billing office. We list the ten registration fields that generate the most denials, show what each error looks like on the remit, and describe the front-desk checks that catch them before the patient reaches the exam room.
Medicaid Work Requirements Arrive in 2027: What Practices Should Set Up Now
The July 2025 reconciliation law requires states to apply an 80-hour monthly work requirement to Medicaid expansion adults by January 1, 2027, with six-month redeterminations. CMS issued initial guidance in December and owes a rule by June 1. Here is what changes for practices and what to do now.
Payment Posting Workflow: Auto-Posting, Manual Posting and Daily Deposit Match
Every report in the billing office is built from posted payments, so late or wrong posting makes every report wrong. We lay out the payment posting workflow we set up: 835 auto-posting rules that don't hide denials, manual posting with control totals, and the daily match of posted batches to bank deposits.
A Monthly Denial Review Template: The Eight Numbers and the One-Page Agenda
Most practices look at denials when cash is short and stop when it recovers. A monthly review with fixed numbers and a fixed agenda turns that into a habit. Here is the template we use: the eight measures, how to pull them, and the forty-minute meeting that goes with them.
CMS 855I, 855B and 855R Explained: Medicare Enrollment Forms for Practices
Medicare enrollment has its own alphabet: the 855I for the individual, the 855B for the group, the 855R to connect them, and PECOS to hold it all. We explain which form does what, the order to file them, what triggers a rejection, and the maintenance rules that keep a practice from being deactivated.
How to Bill a Medicare Annual Wellness Visit (G0438, G0439) Without Denials
The Medicare Annual Wellness Visit pays well, has no patient cost-share and denies constantly for reasons that have nothing to do with medicine. We cover the three codes, the twelve-month rule, what has to be in the note, the same-day problem visit, and the eligibility check that prevents most of the denials.
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