Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
How to Reduce No-Shows in a Medical Practice Without Losing Patients
A 12 percent no-show rate in a four-provider practice is roughly $250,000 of visits a year that never happen. Here is how to measure the rate honestly, the reminder cadence that works, what to do about repeat offenders, when a fee helps and when it drives patients away, and how to fill the gaps that remain.
How to Calculate Days in AR and What the Number Actually Tells You
Days in accounts receivable is the most quoted billing metric and the most misread. Here is the formula, the two ways practices distort it, the ranges we see for independent practices by specialty, and how to split it by payer and aging bucket so it points at something you can fix.
The January Claim Edit Tune-Up: Fee Schedules, NCCI Edits and Payer Resets
Every January the billing system runs on last year's fee schedules, last quarter's NCCI edits and payer policies that quietly reset on the first. Here is the tune-up we run in the first two weeks of the year, with the reports that show whether it worked.
Credentialing vs Contracting vs Enrollment: The Three Steps Practices Confuse
A new physician is not paid until three separate processes finish: credentialing verifies the person, contracting sets the terms, and enrollment loads the provider into the payer system. Here is what each step does, who runs it, how long each takes and where the handoffs fail.
CPT 2026 Is Live: Codes to Load, Retire and Re-Map Before the First Claim Run
The 2026 CPT code set brought 288 new codes, 84 deletions and 46 revisions on January 1. Remote monitoring, AI-assisted services, hearing devices and leg revascularization changed the most. Here is how to work through the update without a wave of CO-4 and CO-181 denials.
The 2026 Medicare Part B Deductible Is $283: What January Remits Will Show
CMS set the 2026 Part B deductible at $283 and the standard premium at $202.90, announced November 14, 2025. From the first visits of the year, most Medicare remits will carry PR-1 instead of payment. Here is how the deductible flows through claims, secondaries and statements, and what the front desk should say.
WISeR Prior Authorization Starts in Six States: What to Submit, When and to Whom
Traditional Medicare now requires prior authorization for a list of services in Arizona, New Jersey, Ohio, Oklahoma, Texas and Washington. Requests are accepted from January 5 and apply to dates of service on or after January 15. Here is the practical setup.
How to Appeal a Timely Filing Denial: CO-29, Proof of Filing and the Letter
CO-29 denials are not always final. Clearinghouse acceptance reports, payer acknowledgments and eligibility history can prove the claim was filed on time or that the clock started later than the payer thinks. Here is what counts as proof, what does not, and the letter we send.
CPT 99214 Documentation Requirements: What the Note Needs Under MDM Rules
Since 2021, an established patient office visit is leveled by medical decision making or total time, not by history and exam bullets. Here is what a 99214 note has to show in each of the three MDM elements, with worked examples, the common downcoding traps and what auditors flag.
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