Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
The Medical Billing Process Explained Step by Step: From Scheduling to Zero Balance
Medical billing is a chain of fourteen linked steps, and a claim is only as clean as the weakest one. We walk the whole process in order, from the first phone call to the day the balance hits zero, with the reports we watch and the places where money quietly leaks.
Payer Portal Access for Billing Teams: Inventory, Delegation and Offboarding
A billing team of four can hold forty portal logins, and nobody knows who has which until someone leaves. Here is how we manage payer portal access: the inventory, delegated administrator roles, same-day offboarding, multi-factor setup and the portal tasks worth batching every morning.
Preparing Front-Desk Collections for the January Deductible Reset
In January most patients owe the full visit cost until the deductible is met. Practices that collect at the desk in January collect it; practices that send statements in March mostly do not. Here is the fourth-quarter plan: deductible data from the eligibility response, estimates, card on file and scripts.
Medicare Open Enrollment Starts October 15: What Plan Exits Mean for Practices
Medicare open enrollment runs October 15 to December 7, 2026, and at least 33 health systems have left or are leaving Medicare Advantage networks while insurers trim their 2027 footprints. Here is what practices should expect in January and what to set up now at the front desk.
How to Benchmark Your Medical Practice Against Survey Data, Without the Traps
A practice owner reads that median days in AR is in the low thirties, sees 47 on her own report, and starts a fire drill. The survey measured something different. Here is how to benchmark your medical practice against survey data: the metrics, computing yours the survey's way, the specialty adjustments and the traps.
Why Completed Encounters Never Become Claims, and How to Catch Them Every Week
The most expensive leak in a medical practice is the visit that was seen, documented and never billed. Here is where unbilled encounters come from, how to measure the gap with three reports you already have, and the two weekly reconciliations that close it.
MIPS 2027 Under the CY 2027 Proposal: New MVPs, Core Measures and a 2029 Sunset
Comments on the CY 2027 fee schedule proposal closed September 14, and the Quality Payment Program section is the part practices have read least. Here is what CMS proposed for MIPS 2027: three new MVPs, core measures, a changed Promoting Interoperability list and the end of traditional MIPS after 2028.
Flu Shot Billing for 2026 to 2027: G0008, Vaccine Codes and Payer Rules
CMS has posted the Medicare Part B payment allowances for 2026 to 2027 influenza vaccines, effective August 1, and clinics are stocked. Here is how we set up flu shot billing for the season: G0008 versus 90471, the product codes, Z23, Medicare Advantage routing, roster billing and the October denials.
Medicaid Work Requirements Start January 2027: Preparing Your Front End
Under Public Law 119-21 and the CMS interim final rule issued June 1, 2026, states must apply an 80-hour monthly community engagement requirement to Medicaid expansion adults by January 1, 2027. Here is what it changes for eligibility, documentation and patient conversations in an independent practice.
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