Resources for Modern Practices
Written for the person who actually has to fix it. No gated fluff, no vendor pitch dressed up as a guide.
Things worth knowing
The Seven Costliest Denial Codes
CO-16, CO-97, CO-50, CO-197 and three more, with the root cause and the corrective workflow for each.
Read articleThe Annual Code Update Playbook
CPT changes in January, ICD-10-CM in October. Here is how to prepare so neither one costs you a quarter of clean claims.
Read articleWhy Your Days in AR Are Higher Than You Think
The metric is easy to calculate, easy to flatter, and easy to misread. What to look at instead.
Read articleWhere Credentialing Actually Stalls
A provider who cannot bill still costs you a salary. Where enrollment stalls, and how to keep it moving.
Read articleTelehealth Billing: POS and Modifiers
The rules changed repeatedly, and the documentation standard did not relax. What to get right.
Read articleNegotiating Better Rates With Commercial Payers
What data to bring, when to ask, and the leverage that actually moves a contract.
Read articleWhat it looked like elsewhere
4-location cardiology group cut denials 62%, lifted NCR from 91% to 97.4%, and recovered $480K in aged AR within 90 days.
Independent IM practice replaced an in-house biller, automated eligibility, and recovered 5 months of stalled credentialing revenue.
22-clinician group rebuilt auth tracking, fixed parity-related denials, and reduced days in AR from 58 to 27 in one quarter.
9-location urgent care chain corrected POS errors, occ-med workflows, and same-day charge entry to lift clean-claim rate to 98%.
Ortho practice fixed global-period leakage, implant documentation, and auth tracking to recover 11 months of underpayments.
Reference lab realigned medical-necessity documentation with LCD/NCD policies and renegotiated 3 commercial payer contracts.
Deeper reference material
The Independent Practice RCM Playbook
A 38-page guide covering eligibility, charge capture, coding, denials, AR, and reporting for solo and small-group practices.
Request copyDenial Prevention Cheat Sheet
Top 25 denial reasons mapped to root causes, payer policies, and the exact corrective workflow for each.
Request copyCredentialing Checklist (US)
Every document, deadline, and payer-specific requirement, Medicare, Medicaid, BCBS, Aetna, UHC, Cigna, Humana and more.
Request copyKPI Dashboard Template
The 12 KPIs every practice owner should track weekly, with formulas and benchmark ranges by specialty.
Request copyHIPAA & SOC 2 Vendor Checklist
What to ask any billing vendor before handing over PHI. BAAs, audit logs, encryption, breach response, access controls.
Request copyNo Surprises Act Quick Guide
Good-faith estimates, IDR process, balance billing rules, and the workflows that keep you compliant.
Request copyWant this applied to your numbers?
We'll send specialty benchmarks and denial trends for your service line, alongside a free audit of your own claims.