Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Denial Trends After the January 2026 Payer Changes: What Q1 Remits Are Showing
Three months of 2026 remittances are enough to see which January changes turned into denials. We walk through the CARC codes that rose this quarter, the payer behaviors behind them, and the fixes that stop each category before April claims go out.
CMS Revised the ABN Form on March 13, 2026: When to Issue It and Which Modifier
A revised Advance Beneficiary Notice of Noncoverage, Form CMS-R-131, was approved on March 13, 2026 and must be in use by May 12. What changed, when an ABN is required, when it is prohibited, how to fill it in, and the GA, GX, GY and GZ modifiers that tell Medicare who pays if the claim denies.
Medical Billing and Coding Certifications Explained: CPC, CPB, CCS and CRCR
Practice owners see CPC, CPC-A, CPB, CCS, CRCR and CPCS on resumes and rarely know what each proves. This comparison explains the major billing, coding, credentialing and revenue cycle credentials, who issues them, what the letters do and do not tell you, and how to test the rest.
Which Vendors Need a HIPAA Business Associate Agreement, and Which Do Not
Every practice has a drawer of business associate agreements and a longer list of vendors that never signed one. What makes a vendor a business associate, twenty common vendors sorted into yes and no, the terms the contract must contain and a two-week inventory plan.
Spring Credentialing Revalidations: PECOS Due Dates and CAQH Attestations
Medicare revalidation notices, CAQH re-attestations and commercial recredentialing cycles tend to pile up in spring. Here is how to read the PECOS revalidation list, what a deactivation actually costs, the 120-day CAQH rhythm, and a tracking sheet that keeps a multi-provider practice from missing one.
Medicare Preventive Services Beyond the Wellness Visit: Screening and Limits
Most primary care offices bill the annual wellness visit and stop. Medicare also pays separately for alcohol screening, depression screening, tobacco counseling, cardiovascular and obesity counseling and a twice-yearly risk assessment, each with its own frequency limit. Here is the list, the rules and a worked visit.
Colorectal Cancer Screening Gaps: A March Workflow for the HEDIS COL Measure
March is Colorectal Cancer Awareness Month, and it is when payer gap lists for the year arrive. How to find every patient aged 45 to 75 without a qualifying screening, which tests close the gap and for how long, the Medicare and commercial codes, and a tiered outreach plan a small practice can run.
HIMSS26 in Las Vegas: What Independent Practices Should Actually Watch
The HIMSS Global Health Conference runs March 9 to 12, 2026 at the Venetian in Las Vegas, with more than 600 sessions on AI, cybersecurity and interoperability. Most of it is aimed at health systems. Here is what will reach a ten-provider practice within a year, and how to vet the vendors who come back from it.
Behavioral Health Integration Billing: 99484, CoCM, G0323 and the 2026 Add-Ons
Most primary care offices screen for depression and then have nowhere to send the positives. Behavioral health integration billing pays for doing the follow-up in-house. We walk through 99484, the collaborative care codes, G0323 for psychologists and social workers, and the APCM add-ons that arrived in January 2026.
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