Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
PCMH Quality Measure Dashboards: Choosing Measures, Setting Goals, Reporting
The quality improvement concept in PCMH is where practices produce the most paper and the least change. We describe a quality measure dashboard that satisfies the QI criteria and actually runs the practice: which measures to pick, how to set a defensible goal, how to report to clinicians, and what evidence to keep.
After-Hours Codes 99050, 99051, 99058 and S9088: Which Payers Actually Pay Them
Evening and Saturday clinics cost more to staff, and CPT has add-on codes for that. Whether anyone pays them is another matter. We explain what 99050, 99051, 99058 and S9088 describe, how Medicare, Medicaid and commercial payers treat each, what the note must show, and how to bill them without denial noise.
Summer Credentialing: Fix the Enrollment Gaps You Will Pay for in January
July and August are when new physicians start, revalidations quietly come due and payer rosters drift out of date. The practices that treat summer as credentialing season avoid the January surprises: retroactive denials, held claims and providers who cannot bill the plans they see. Here is the summer checklist we run.
Fracture Care Coding: Global Care vs E/M Plus Casting, and When Each Is Right
A closed fracture treated in the office can be coded two legitimate ways, and the choice changes what you bill for the next 90 days. We explain the global fracture care codes, the E/M plus casting alternative, the modifiers each needs, a distal radius example, and the mistakes that produce denials.
CY 2027 Physician Fee Schedule Proposal: Conversion Factor Falls to $32.84
CMS released the CY 2027 Medicare Physician Fee Schedule proposed rule on July 14, 2026. The 2.5 percent bump expires, the conversion factor drops to $32.84, G2211 becomes a 16 percent modifier and same-day E/M visits with globals are cut in half. What happened and what to do before September 14.
Medical Records Retention: How Long to Keep Charts, Claims and Remits, by Rule
Practices keep everything forever because nobody knows which rule applies, and then a storage unit or an old server becomes the breach. We sort out the retention clocks that apply to a physician practice, HIPAA, state law, Medicare Advantage, OSHA and payer contracts, and describe how to destroy records properly.
Billing Staff Productivity Benchmarks: Claims per FTE and Touches per Claim
Most practices measure billing staff by how busy they look. We lay out the numbers that actually describe a billing office, claims per FTE, touches per claim, denials resolved per day and posting speed, show how to pull them from your own system, and pair each with an accuracy measure so speed never beats correctness.
Nursing Facility Visit Coding for Rounding Physicians: 99304 to 99316 Explained
Physicians who round at nursing facilities lose more revenue to uncaptured visits than to denials. We explain the 99304 to 99316 codes as they have worked since the 2023 changes, the MDM and time thresholds, who may perform which visit, and a census reconciliation that finds the visits that never became claims.
Cyber Insurance for Medical Practices: What the Application Asks and What Pays
The cyber insurance application has become a security audit, and the answers you give are the ones the carrier will hold you to after a ransomware event. We explain what the application asks, what a claim actually pays and does not, and the controls that lower premiums and keep the policy from being rescinded.
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