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Medicare

What Is PECOS? How Medicare’s Provider Enrollment System Works and Why It Matters

January 31, 2026 / Alex J. Lau / CMS, Medicare, Medicare Enrollment, PECOS
Female Medical Doctor PECOS User

PECOS, the Provider Enrollment, Chain, and Ownership System, is the CMS web-based portal through which healthcare providers and suppliers enroll in Medicare, update their enrollment information, and manage their participation status. Any provider who wants to bill Medicare for services must have an active, accurate PECOS enrollment record. Billing Medicare without an active enrollment, or […]

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CMS, Medicare, Medicare Enrollment, PECOS

Getting In-Network with Medicare

October 9, 2025 / Alex J. Lau / Medicare
Medical Doctor in Need of Credentialing

For healthcare providers looking to expand their patient base and establish a stable revenue stream, becoming an in-network Medicare provider represents a significant opportunity. With over 66 million Americans enrolled in Medicare, this federal health insurance program serves as a cornerstone of healthcare coverage in the United States. However, the process of joining Medicare’s network […]

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In-Network Credentialing, In-Network with Medicare, Medicare, Medicare In-Network

Medicare Reimbursement: Understanding the Labyrinth

April 3, 2024 / Alex J. Lau / Medicare
Medicare Labyrinth

If you’re a healthcare provider or facility dealing with Medicare, one thing is certain, getting properly reimbursed is a maze filled with complex rules, convoluted paperwork, and often, sheer frustration. Medicare reimbursement is the lifeblood that keeps many healthcare operations afloat, but navigating its serpentine pathways can feel like a daily battle. Buckle up as […]

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CMS, Geographical Practice Cost Index, Inpatient Prospective Payment System, IPPS, Medicare Billing, Prospective Payment Systems

Skilled Nursing Facility Versus Nursing Home

December 18, 2022 / Alex J. Lau / Medical, Medical Billing, Medical Providers, Medicare, Medicare Coverage, Nursing Home, Old Folks Home, Skilled Nursing, Skilled Nursing Billing, Skilled Nursing Facility

What’s the Difference Between a Skilled Nursing Facility and a Nursing Home? On the surface, a skilled nursing facility and a nursing home may appear rather the same. In fact, some care facilities actually function as both, with a distinct floor or section of a building dedicated to each. The difference between a skilled nursing […]

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Billing, Medical Billing, Medical Billing Service, Nursing Billing, Nursing Facility Billing, Nursing Home, Old Folks Home, Skilled Nursing, Skilled Nursing Billing, Skilled Nursing Facility, Skilled Nursing Facility Billing

Medical Billing Myths

July 31, 2021 / Alex J. Lau / Full Service Medical Billing, Healthcare, Medicaid, Medical Billing, Medical Billing Companies, Medical Billing Myths, Medicare, What is Medical Billing?
Medical Billing Experts

Understanding Medical Billing Myths Dr. John Smith owns a small practice in Pittsburgh’s South Hills. He’s in the midst of a conversation with one of his nurses. Nurse: “Doctor, do you think we should be posting signs concerning the payment of co-pays once the patient is finished with their appointment?” Doctor: “I agree to a […]

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Healthcare Billing, Healthcare Providers, Medical Billing, Medical Billing Myths, Medical Billing Service, Outsource Billing, Outsource Medical billing, Outsourced Billing, Pittsburgh Medical Billing

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    The Ghost Provider Problem: CAQH Lapse & Denials

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Recent Posts

  • Denied Medical Claim Appeal Letter

    Why an Approved Authorization Can Still End in a Denied Claim

  • AI Scribes Changing Medical Coding and Billing

    AI Scribes are Changing Medical Coding, Reimbursement

  • Net Collection Rate, analyzed by analyst

    What’s a Net Collection Rate in RCM?

  • Modifier 96 versus Modifier 97

    Modifier 96 vs. Modifier 97: What Therapy Billers Need to Know

  • 'Revalidation versus Recredentialing' Neon Sign

    Revalidation vs. Recredentialing: What’s the Difference? (2026 Guide)

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