Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
Card on File Policy for Medical Practices: Consent, Limits and the Workflow
Keeping a patient's card on file and charging the balance after the claim adjudicates can cut patient AR sharply, or generate complaints and chargebacks if done carelessly. Here is the policy we recommend: the consent form, the dollar cap, the notice before the charge, and the technology rules.
How to Build a Medical Practice Revenue Budget From Your Own Billing Data
Most practice budgets start from last year's deposits plus a percentage, which misses every fee schedule change and payer mix shift in your own data. Here is how to build a medical practice revenue budget from visits, payer mix, contracted rates and collection rates, with a worked example.
HCC Coding for Primary Care Practices: What Risk Adjustment Means on Claims
Medicare Advantage plans are paid based on the diagnoses your claims carry, and they know which of your patients have conditions not yet coded this year. Here is how hierarchical condition categories work, what CMS-HCC version 28 changed, the documentation rule and a capture workflow.
2027 MA Advance Notice: What the Audio-Only Change Means for Practices
CMS released the 2027 Medicare Advantage and Part D Advance Notice on January 26, 2026, proposing a nearly flat payment update and excluding diagnoses from audio-only visits and unlinked chart reviews from risk adjustment. Here is why practices, not just plans, should read it.
Medicare Telehealth Flexibilities Expire January 30, 2026: A Plan for February
The continuing resolution signed November 12, 2025 extended Medicare telehealth flexibilities only through January 30, 2026. Unless Congress acts within days, home-based and audio-only telehealth for most Medicare patients loses coverage January 31. What stops, what continues, and a February plan.
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.
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.
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The same people who write these articles run billing, coding, denial management and credentialing for practices nationwide.