Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
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.
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.
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.
A 2026 Credentialing Calendar: Revalidations, Re-Attestations and Renewals
Credentialing work that is missed does not announce itself until a claim denies or a payer terminates the provider. Here is the calendar we keep for every provider: the 120-day CAQH cycle, Medicare revalidation, payer recredentialing, licenses, DEA, CLIA and the 30-day NPPES rule.
How to Set Up a New Payer in the Practice Management System Before Go-Live
A signed contract is not a payer that pays. We walk through the payer record and its three different IDs, EDI, ERA and EFT enrollment, loading the contracted fee schedule with a worked example, and the watched first claim that proves every link works before the rest go out.
Medicare Advantage Open Enrollment Runs Through March 31, 2026: A Practice Plan
The Medicare Advantage Open Enrollment Period runs January 1 to March 31, 2026, and this year it follows a record wave of plan exits. Patients who switched, or were switched, are arriving with cards that do not match your file. Here is what the period allows and the checks to run.
Claim Rejection vs Denial: What the 277CA and the 835 Are Telling You
A rejected claim never entered the payer's system; a denied claim did and was refused. The two need different fixes, deadlines and reports, and practices that treat them the same lose claims to timely filing. Here is how to tell them apart, where each surfaces, and the workflow for both.
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The same people who write these articles run billing, coding, denial management and credentialing for practices nationwide.