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Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Building the Evidence File for PCMH Annual Reporting Under Standards 11.1
PCMH annual reporting is a documentation exercise, and the practices that struggle are the ones that start collecting evidence a month before the due date. Here is how we build the evidence file across the year under NCQA Standards Version 11.1, what changed in 2026, and the reports that satisfy reviewers.
PCMH Annual Reporting in a Year of Coverage Churn: Keeping Panels Honest
Recognized practices report to NCQA every year, and 2026 is a year when panels are about to move: Medicaid six-month renewals and work requirements arrive in December and Marketplace premiums are rising for 2027. Here is how to keep empanelment, quality data and care management accurate through the churn.
How to Prepare a Practice for PCMH Recognition: The Order of Work That Holds Up
Recognition follows workflows, not binders. A practical order of work for practices starting toward the medical home: a champion with protected time, an honest assessment, access and coordination workflows first, EMR reports confirmed early, an evidence library built as you go, and a plan for annual reporting.
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.
A Patient Experience Survey for PCMH: Questions, Sample Size and What to Change
NCQA expects a recognized medical home to survey patients across at least three dimensions and act on the results. Here is how to build a patient experience survey for PCMH: which CAHPS-style questions to ask, how many responses you need, how to score them and how to turn a low score into a change.
PCMH Annual Reporting: A Mid-Year Check and NCQA's Proposed 2027 Changes
Recognized practices report to NCQA once a year, and the ones that struggle are the ones that start in the month it is due. Here is the June check we recommend, the evidence that takes longest to assemble, a worked care management example, and what NCQA proposed this spring for the Care Management criteria in 2027.
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.
Closing Care Gaps Before Mid-Year: Turning Q1 Payer Gap Lists Into Visits
Payer gap lists for measurement year 2026 arrived in the first quarter and most of them are sitting in an inbox. April to June is when closing them is easiest. Here is how to reconcile the lists against your own data, which measures to prioritize, how to code closures so they count, and how to run the outreach.
A Pre-Visit Planning Template for Primary Care: The Huddle That Closes Care Gaps
Most care gaps that stay open were missed at a visit where the patient was already in the room. We share the pre-visit planning template for primary care we build with practices: who does it, what fields it has, how the ten-minute morning huddle uses it, what it does for PCMH evidence and the numbers to track.
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The same people who write these articles run billing, coding, denial management and credentialing for practices nationwide.