Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
What Practices Should Review Before Outsourcing Medical Billing
Outsourcing billing changes who does the work, not who is responsible for the revenue. Here is what to examine in your own practice first, the questions that separate a billing company from a claim-submission service, and what the agreement must say.
Billing Supplies in the Office: 99070, HCPCS A Codes and What Payers Bundle
Splints, slings, dressings and trays leave the supply closet every day, and most of them never reach a claim. We explain when 99070 works and when it never will, which HCPCS A, Q and L codes payers actually pay, what NCCI bundles into the procedure, and where the supply dollars are worth chasing.
Coding Education for New Providers: A Six-Week Onboarding Plan
New physicians and advanced practice providers starting this summer learned medicine, not billing. The first ninety days set habits that last a career. Here is the six-week coding curriculum we use, what to audit at day 30 and day 90, and the five mistakes new providers make most often.
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July and August are when new physicians start, revalidations quietly come due and payer rosters drift out of date.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.
Workers' Compensation Billing for Practices: Authorization, Fee Schedules, Forms
Workers' compensation claims follow state rules, not payer contracts, and most billing teams learn them by losing money. We cover what to capture before the first visit, how state fee schedules and filing limits work, the reports that must ride with every bill, and the denials that follow when they do not.
Qualified Medicare Beneficiary Billing Rules: Spot QMB Status, Refund Mistakes
Federal law bars practices from billing Qualified Medicare Beneficiaries for Medicare deductibles, coinsurance and copays, yet statements still go out to them. We explain how QMB works, where the status shows up on eligibility and remits, how to post the balance, and how to refund what was collected in error.
UnitedHealthcare July 2026 Policy Updates: What Your Practice Should Check
UnitedHealthcare posted its July 2026 monthly overview and policy bulletins on July 1. Most items are quarterly code housekeeping, but a DME process change in eleven states, three prior authorization changes with fall dates and several state Medicaid items deserve a look now.
Teaching Physician Billing Rules in a Private Practice: GC, GE and Being Present
When residents rotate through a private practice, Medicare pays the teaching physician only if the presence and documentation rules are met. Here is what "present for the key portion" means, when modifiers GC and GE apply, how the primary care exception works and what changed on January 1, 2026.
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