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Clear, practical answers for providers of every specialty: credentialing, billing, regulations, starting a practice and finding new patients.
MedicareNew−2.31%Medicare pay cut on Jan 1Medicare's 2027 conversion factor drops to $32.63, a 2.31% cut starting Jan 1, 2027. Here's what it means for practice revenue and 6 steps to take now.
RoundupNew7 guidesNovember 2026 updatesPlain-English roundup of the Medicare, Medicaid and payer billing changes practice owners need to know for late 2026 and January 2027, with what to do about each.
MedicareNew80%lower-paid same-day serviceFrom Jan 1, 2027, Medicare pays 80% for the lower-paid service when a modifier 25 visit and a 0-day global procedure happen the same day. What to do.
MedicareNewB1 / B2replace G2211 in 2027In 2027 Medicare replaces G2211 with modifier B1 (+16% to the E/M payment) and B2 (+32% for ACO and LEAD participants). Here's how to update your billing.
MedicareNewG0572new advance care planning codes2027 Medicare rules: initiating visit for RPM/RTM, RTM for established patients only, new ACP codes G0572/G0573 and group-visit codes. What to change.
MedicaidNew11 testsUHC Medicaid lab limitsUHC Medicaid plans now limit testosterone, B12, liver fibrosis, allergy and other lab tests. See which tests, which states, the dates and what to do.
MedicaidNew−50%KY same-day sick + preventiveUHC Medicaid: 50% cut for same-day sick + preventive visits in KY, lower modifier 78 pay in MA/MD, multi-procedure cuts in WI, OB changes in 2027.
No Surprises ActNew2 IDRscan't take new disputesFederal regulators removed IDR entities IPRO and Network Medical Review on Nov 4, 2026. What it means for practices with open or new payment disputes.
Medicare AdvantageNew~1Mseniors losing their planAbout 1 million seniors lose their Medicare Advantage plan on Dec 31. Here's how your practice can keep patients and avoid denials.
BillingNewJan 1new maternity codesStarting January 1, 2027, prenatal care, delivery and postpartum care will be billed separately under new CPT codes. What changes and what your practice should do now.
Prior authorizationNew72 hurgent response limitPrior approvals go electronic on Jan 1, 2027 for Medicare Advantage, Medicaid and ACA plans. Here's what it means and how to get ready.
MedicaidNew80 hrsa month to keep coverageMedicaid work rules start Jan 1, 2027. Learn how they affect your patients and revenue, and the simple steps your practice can take now.
ACA marketplaceNewNov 1open enrollment startsACA marketplace patients will pay more in 2027. Here's how the changes affect your practice and simple steps to keep patients covered.
ComplianceNewOct 14CMS gains exclusion powerCMS can now ban providers from Medicare and Medicaid on its own. Here's what changed and 6 simple steps to protect your practice.
ComplianceNewDOJthe right door to reportA new DOJ and HHS-OIG policy says possible criminal healthcare fraud should be reported to the Justice Department. What it means for your practice and what to do now.
Medicare AdvantageNew90 daysdirectory checks proposedCMS wants Medicare Advantage plans to fix wrong doctor listings. Here's what the proposed rule means and how to make sure you're listed right.
Billing & paymentsNew2028proposed end of arbitrationA new bill would end No Surprises Act arbitration in 2028. Here's what it means for out-of-network practices and what to do now.
MedicaidNew$2.5BMedicaid funds on holdThe federal government is holding back $1.2B more in California Medicaid funds. Here's what it means for Medi-Cal providers and how to prepare.
Practice growthNewM&Ahospital deals near youHospital systems keep buying each other. How a nearby merger can affect referrals, insurer bargaining, staffing and buyout offers for independent practices, and what to do now.
RegulationsIs a DEA license state specific? Is a CSR the same as DEA? Clear answers on federal DEA registration and state controlled substance licenses for prescribers.
CredentialingHow insurance credentialing works for physicians, NPs, PAs and therapists: documents, CAQH, Medicare and Medicaid enrollment, timelines and common delays.
RegulationsHow California's AB 890 works for nurse practitioners: 103 NP and 104 NP requirements, transition to practice hours, practice settings and how to apply.
Starting a practiceHow to open a certified rural health clinic in Louisiana: location and shortage-area rules, NP and PA staffing, physician direction and certification.
Starting a practiceA step-by-step guide for PMHNPs opening a private practice: practice authority, DEA, credentialing, telehealth, billing and finding patients.
CredentialingHow hospital privileges work for physicians, NPs and PAs: types of privileges, the application process, timelines and how affiliations help you grow.
Patients & marketingWhat patient acquisition means in healthcare, strategies that bring new patients to practices of every specialty, and how to measure cost per patient.
Starting a practiceA step-by-step plan to start a medical practice in any specialty: practice model, business setup, licenses, credentialing, systems, budget, launch and timeline.
BillingHow to set up medical billing for a private practice: in-house vs. outsourced, software, clearinghouse, workflows, KPIs and costly mistakes.
BillingRevenue cycle management for small practices: each stage from scheduling to payment, where revenue leaks, KPIs, and in-house vs. outsourced RCM.
BillingHow AI and automation are changing medical billing for independent practices: what works today, where people are still needed, privacy risks and how to start.
BillingBilling strategies for family medicine practices: preventive and sick visits, modifier 25, annual wellness visits, care management and denials.
OperationsWhat a healthcare practice management company does, which tasks practices outsource, what it costs, and how to choose a partner for a practice of any specialty.
OperationsPractical ways for nurse practitioners, physicians and therapists who own a practice to reduce burnout and take back time from administrative work.
OperationsHow to choose EHR software for your medical practice: specialty fit, billing integration, e-prescribing, telehealth, costs, contracts, demos and data migration.
Patients & marketingHow a weak patient intake process wastes marketing spend and loses new patients, and how to fix calls, forms, insurance checks and follow-up for any specialty.
Patients & marketingHow online provider directories help patients find and choose your practice, which directories matter for each specialty, and how to keep listings accurate.
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