Direct and general supervision decide who bills, at what rate, and whether the claim holds. A payer and state map of the rules, plus the proof auditors want.
Supervising Physician Rules by Payer and State Read More »
One calendar for every provider, payer and deadline, plus a ninety day review rhythm that catches a recredentialing gap before claims do.
The Recredentialing Calendar Every Practice Needs Read More »
PECOS runs on an I&A account, and the roles behind it decide who can sign what. Set up access, identity verification and a backup user before a deadline.
PECOS: Setting Up Access Before You Need It Read More »
The documents to gather before the first payer application, the order to file in, and how to keep cash moving while enrollment is still open.
Payer Enrollment Checklist: Stop New Provider Cash Gaps Read More »
Uninsured and self-pay patients are owed a written, itemized good faith estimate on a clock. Learn the content rules, the timing, and the $400 dispute.
The Good Faith Estimate: Compliance Basics for Practices Read More »
A wrong place of service code prices a claim at the wrong rate. See the codes that change Medicare payment, the facility gap, and the traps.
Place of Service Codes That Change Payment Read More »
An insurance records request is a claim on a clock. Learn the Medicare response windows, what to send, when a copy fee is allowed, and the aging trap.
Medical Record Request From Insurance: Deadline Rules Read More »
What a payer must tell you and your patients before a contract ends, the 90-day continuity window, and the revenue plan for the quarter after.
Insurance Contract Termination: The 90-Day Notice Read More »
How ASAM levels of care set SUD billing codes, trigger prior authorization, and drive the concurrent review that keeps treatment days covered and paid.
Substance Use Disorder Billing: Levels of Care and Authorization Read More »
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 »
