An escalation ladder for collecting patient balances: the statement, the reminder cycle, payment plans, agency placement, and the rules that govern each step.
Collecting Patient Balances Without Damaging Relationships Read More »
How NCCI PTP and medically unlikely edits work, when modifier 25, 59 or an X modifier is defensible, and how to tell a coding error from a payer error.
NCCI Edits: When a Bundling Denial Is Correct Read More »
Build one page per payer with their denial reasons, appeal address, filing windows and documentation quirks, plus the person who owns it.
Payer Denial Playbook: One Page Per Payer Read More »
NCQA sets the verification windows, the three-year recredentialing cycle and the evidence a payer audits under a delegation. Here is what each step requires.
NCQA Credentialing Standards in Plain English Read More »
How the free care reversal changed school based medicaid billing, the consent and documentation rules, and the supervision that keeps claims paid.
School Based Medicaid Billing: Behavioral Services Read More »
