Practical knowledge from people who do the work.
Medical billing, coding, denials, credentialing, PCMH and practice operations, written to be useful on Monday morning.
CAQH Attestation and Credentialing Renewals to Finish Before January 1
Licenses, malpractice policies, payer recredentialing and new-provider start dates all cluster around January 1. Here is the fourth-quarter credentialing checklist: CAQH re-attestation, expiring documents, Medicare revalidation dates, roster checks and the lead times payers actually need.
Medicare Open Enrollment Starts October 15: What Plan Exits Mean for Practices
Medicare open enrollment runs October 15 to December 7, 2026, and at least 33 health systems have left or are leaving Medicare Advantage networks while insurers trim their 2027 footprints. Here is what practices should expect in January and what to set up now at the front desk.
How to Benchmark Your Medical Practice Against Survey Data, Without the Traps
A practice owner reads that median days in AR is in the low thirties, sees 47 on her own report, and starts a fire drill. The survey measured something different. Here is how to benchmark your medical practice against survey data: the metrics, computing yours the survey's way, the specialty adjustments and the traps.
NPI Type 1 vs Type 2: Rendering, Billing and the Setup Errors That Deny Claims
Every claim carries at least two provider identifiers, and when they are set up wrong the claim fails before anyone reads it. Here is how Type 1 and Type 2 NPIs work, where each goes on the claim, how reassignment and taxonomy codes tie them together, and the six setup errors behind most provider denials.
Physical Therapy Billing in a Physician Practice: Units, KX and Plan of Care
Adding a physical therapist to an orthopedic or primary care practice adds a billing rulebook nobody on the staff has read. Here is how physical therapy billing in a physician practice works: counting timed units under the 8-minute rule, the 2026 KX threshold, plan of care certification and the PTA modifier.
Common Credentialing Delays and How Practices Can Prepare for a New Provider
Most payer enrollment delays are caused before the application is submitted. Here is what payers reject, what they wait for, a realistic timeline by payer type, and the preparation checklist to start the day an offer is accepted.
Telehealth Across State Lines: Licensure, Payer Rules and Compact Options
A video visit with a patient who is sitting in another state is practicing medicine in that state. Here is how we handle telehealth across state lines: where the license has to be, what Medicare, Medicaid and commercial plans require, the DEA rules for prescribing, and which licensure compacts are worth the paperwork.
Credentialing in September for January: Revalidations, Contracts, New Plans
January 1 is when payer contracts renew, plan networks change and revalidations that were ignored all year come due. Here is the September credentialing review we run for practices, with the checks, the deadlines and the file you should be able to produce for every provider.
The Fourth-Quarter Denial Sweep: Appeal What You Can Before Deadlines Close
September is the last comfortable month to rescue denials from the first half of the year. Here is how we run a fourth-quarter denial sweep: which remark codes to pull first, how to sort by appeal deadline instead of dollar value, and the write-off rules that keep the list honest.
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