CAQH, PECOS, and NPI: a simple guide for new providers
Three systems sit underneath almost every enrollment. Here is what each one does, who needs it, and how to keep them in sync.
3 min read
Resources
Plain language guides for practice owners.
Short, practical guides on billing, credentialing, denials, and AR. Written for owners and managers, with clear next steps.
Featured guide ยท Credentialing
How long does provider credentialing take, and what slows it down?
Credentialing timelines depend on the payer, the paperwork, and how fast gaps get fixed. Here is what drives the clock and how to keep it moving.
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Top 10 denial reasons and how to fix them
Most denials come from a short list of causes. Here are ten we see often, what each one means, and the fix that stops it repeating.
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What is a clean claim, and why does it matter?
A clean claim is one the payer can process without asking for anything else. Here is what that means in practice and how to send more of them.
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AR days: what they mean and how to bring them down
Days in accounts receivable shows how long it takes to turn services into cash. Here is how to read it and practical ways to bring it down.
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Eligibility checks: 5 mistakes that cause denials
Eligibility problems start at the front desk and show up weeks later as denials. Here are five common mistakes and how to avoid them.
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Prior authorization: a checklist for busy practices
Missing authorizations turn finished work into denials. Use this checklist to know when auth is needed, what to send, and how to track it.
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Physical therapy billing: units, modifiers, and common errors
PT billing is unit heavy and payer specific. Here is how timed units work, which modifiers matter, and the errors that cause most PT denials.
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Chiropractic billing: active care, maintenance, and Medicare
Medicare pays chiropractors for active treatment, not maintenance. Here is how to document the difference and avoid common chiropractic denials.
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PIP billing in Florida: what practices need to know
Florida's personal injury protection rules affect when care is covered, how much is available, and how claims should be billed. Here are the basics.
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Workers comp billing: payer, auth, and documentation
Workers compensation claims follow state rules, not health plan rules. Here is what to collect, how authorization works, and what slows payment.
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Old AR recovery: where to start
Old unpaid claims are not all lost. Here is how to sort aged AR, decide what is still collectable, and work it in the right order.
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Medical coding audits: what to check first
A coding audit does not need to be huge to be useful. Here is how to pick a sample, what to check first, and how to turn findings into fewer denials.
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How to choose a medical billing company
The right billing partner depends on your specialty, systems, and what you want to keep in house. Here are the questions worth asking before you sign.
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In house billing vs outsourcing: a practical comparison
Keep billing in house, outsource it, or mix both? Here is a practical look at the trade offs, and the questions that point to the right choice.
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Telehealth billing: what changed and what to check
Telehealth rules have changed many times since 2020, and payers do not all follow the same ones. Here is what to check before you bill a virtual visit.
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Re credentialing: do not let enrollment lapse
Getting enrolled is only the start. Re credentialing, revalidation, and expiring documents can quietly stop payments. Here is how to stay ahead.
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Patient statements: clear, correct, and on time
Patient balances are a growing share of practice revenue. Here is how to send statements patients understand, and a process that keeps balances moving.
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Denial appeals: what to include and when to appeal
Not every denial should be appealed, and a weak appeal wastes time. Here is how to decide, what a strong appeal includes, and the deadlines to watch.
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Starting a new practice: enrollment and billing checklist
Opening a practice means setting up enrollment and billing before the first patient. Use this checklist to plan the steps in the right order.
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