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 Practice Write-Off Policy: Adjustment Codes and Where Money Disappears
Every dollar a practice fails to collect leaves through an adjustment code, and most practices have one or two codes doing all the work. Here is a write-off policy that separates contractual adjustments from real losses: the codes we insist on, approval thresholds and the monthly report.
Re-Verifying Patients Who Lost Marketplace Subsidies: A January Workflow
The enhanced premium tax credits expired on December 31, 2025, and many marketplace patients arrived in January with a new plan, a new network or a grace-period notice. Here is how to re-verify every marketplace patient and avoid the retroactive termination denials that follow.
How to Read an ERA: The 835 Remittance Advice, CARC, RARC and Group Codes
The electronic remittance advice is the payer's answer to every claim you send, and most physicians have never looked at one. Here is how to read an ERA line by line: the claim and service segments, the CO, PR, OA and PI group codes, the reason and remark codes, and five patterns that signal trouble.
Cross-Training a Small Billing Team So One Absence Does Not Stop Cash
In a two- or three-person billing office, one vacation can stop payment posting for a week and one resignation can stall claims for a month. Here is how we cross-train small teams: the task inventory, the primary and backup grid, the shadowing schedule, one-page procedures and a real test.
How to Choose a Practice Management System: What Billing Needs From It
Most practice management system demos are run for the physician and the front desk, and the billing team gets twenty minutes at the end. Here is what billing actually needs: the eligibility, claim, remittance, reporting and contract features to test, the data ownership questions and a scoring sheet.
MIPS 2025 Submission Is Open: A Twelve-Week Plan to Get Data In Before March 31
The 2025 MIPS performance year submission window opened January 2 and closes March 31, 2026 at 8 p.m. Eastern. Here is how we sequence the work: eligibility checks, quality measure completeness, promoting interoperability attestations and improvement activities.
Deductible Season Collections: A Front Desk Plan for the First Quarter of 2026
Deductibles reset on January 1, the Part B deductible is $283 this year, and many marketplace patients moved to bronze plans with higher out-of-pocket costs. Here is how we set up time-of-service collections, estimates and payment plans for the first quarter.
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.
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.
Page 11 of 18 · 156 articles
Want this level of attention on your own revenue cycle?
The same people who write these articles run billing, coding, denial management and credentialing for practices nationwide.