Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
State Prompt Pay Laws: The Clean Claim Clock and How to Collect the Interest
Almost every state gives a payer 30 to 45 days to pay a clean claim and charges interest when it is late, but the interest rarely arrives on its own. Here is how the clean claim clock works, what Texas, New York, California and Florida require, which plans are exempt, and how to bill the payer for what it owes.
Medicaid Provider Tax Changes on June 30 and October 1, 2026: What They Mean
Two dates this year begin the unwinding of Medicaid provider taxes under last year's budget law: non-uniform managed care tax arrangements end with most state fiscal years on June 30, and provider tax rates are frozen from October 1. What the law does, the phase-down that follows, and why practices should care.
Pre-Service Financial Clearance for Procedures: Verify, Estimate, Collect
Pre-service financial clearance means knowing, before the patient arrives for a procedure, that coverage is active, authorization is in hand and the patient knows what they owe. Here is the timeline, the benefit fields to read, a worked estimate and the script that collects it.
OIG Exclusion Screening for a Medical Practice: Monthly Checks, What a Hit Means
OIG exclusion screening means checking every employee and vendor against the LEIE and your state Medicaid list every month. Here is who to screen, how to run the check so it holds up, what a match actually costs, and the steps to take in the first week after a hit.
Mid-Year 2026 Breach Review: Clearinghouses and Vendors Are the Weak Point
Through May, the largest healthcare breaches of 2026 have hit a clearinghouse, a dermatology management company, a hospital and a benefits administrator, with more than 21 million people affected. What the first half shows, why business associates dominate the list, and the vendor questions every practice should ask.
Writing a Patient Financial Policy: The Nine Clauses and the Words to Use
A patient financial policy is the document your front desk points to when a patient objects to paying. Most are either two vague paragraphs or four pages nobody reads. Here are the nine clauses a policy needs, sample wording for each, the legal lines not to cross, and how to roll it out without a fight.
AMA 2026 Annual Meeting: The New Prior Authorization Policy on AI Denials
At its Annual Meeting in Chicago, June 5 to 10, 2026, the AMA House of Delegates adopted policy pushing for AI-informed coverage denials to be reviewable by a licensed physician in the same specialty. Here is what was adopted, what it does and does not change, and how to use it in appeals today.
Revenue Cycle KPIs Explained for Physicians: Clean Claim Rate, Days in AR, More
Most practice owners get a monthly report full of revenue cycle KPIs and trust none of them. This glossary explains the ten that matter, gives the formula for each, the commonly quoted benchmark, the way each one gets gamed, and a worked example from a four-provider practice.
CMS Publishes the Medicaid Work Requirement Rule: What Practices Should Prepare
On June 1, 2026 CMS released the interim final rule implementing Medicaid community engagement requirements for expansion adults, due in every affected state by January 1, 2027. What the rule requires, who is exempt, how coverage will be lost, and what a practice's front desk and billing team should change first.
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