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RCM insights for growing practices

Practical, no-jargon guidance on billing, denials, credentialing and getting paid faster, written by the team that does this work every day, not a content mill.

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Billing: Clean claims & charge capture
Denials: Prevention & appeals
Credentialing: Enrollment & revalidation
A/R: Days, aging & collections

Guides for practice owners

Full answers to the questions we hear most, with the rules and sources behind them.

How to calculate days in A/R
The formula with a worked example and a calculator, the benchmarks, why a good average can hide old claims, and the fixes that bring days in A/R down.Medical billing · 9 min read
How much do medical billing services cost?
The four ways billing companies price their work, the fees that sit outside the rate, and in-house arithmetic built from BLS data, so you can compare quotes on your own numbers.Medical billing · 10 min read
Get credentialed with insurance
Every step from NPI to a loaded contract, in the order that saves weeks, with what goes wrong at each one and how to keep it from happening to your file.Credentialing · 9 min read
What a medical virtual assistant does
The work a medical VA can take over, the HIPAA rules that apply once they touch patient data, and what they cost next to hiring locally.Virtual assistants · 9 min read
Medical practice website design
The rules that actually apply, the deadlines that are real, and the pages patients look for before they pick up the phone.Web design · 10 min read
How long does credentialing take?
Credentialing times by payer, the rules that set your effective date, and a 120-day plan that keeps a new provider from seeing patients you cannot bill for.Credentialing · 10 min read
Custom software for medical practices
The short answer: keep the systems that hold your records and build the gap. Here is how to tell which gap is worth building, and what the API and HIPAA rules require.Software · 10 min read

Six fixes worth knowing

Your clean-claim rate beats your fee schedule
A three-point jump in first-pass acceptance usually adds more to your bottom line than renegotiating a fee schedule. Every reworked claim burns staff time and delays cash, so fixing the front end pays you back first, and keeps paying.
The same-day visit you’re probably underbilling
When a patient comes in for a wellness visit and you also address a real problem, both are billable when you append modifier 25 to the problem visit. It’s one of the most commonly dropped charges in primary care.
Modifier 25: when it saves a claim, when it flags one
Modifier 25 rescues a legitimate same-day E/M performed alongside a procedure, but leaning on it too hard is an audit red flag. The fix is documentation that clearly separates the two services, not avoiding the modifier.
Enrollment gaps quietly cost you 60–90 days
A provider seeing patients before enrollment is final often means 60–90 days of revenue you can’t bill, or get clawed back later. Start credentialing the day you sign the contract, not the day they start seeing patients.
When a screening colonoscopy becomes diagnostic
Find and remove a polyp during a screening colonoscopy and the procedure is now diagnostic. Without modifier 33 or PT, the patient gets a surprise bill and you get a denial: a classic, avoidable GI revenue leak.
The three A/R numbers that actually matter
Days in A/R, the percentage over 90 days, and your net collection rate tell you in about thirty seconds whether your billing is healthy. If nobody is watching these every week, revenue is slipping and you can’t see it.