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  • Posts tagged "Medicare Billing"

Posts tagged "Medicare Billing"

Group NPI or Individual NPI: Which Fits Your Practice?

December 26, 2025 / admin / Articles, CMS-1500, Group NPI, Individual NPI, Medicaid, Medicaid Billing, Medicare, Medicare Billing, National Provider Identifier, NPI, NPPES, Private Insurance, Provider NPI, PTAN
White Male Doctor Talking to a Female Hispanic Woman

Small details can make or break your revenue cycle. One of the most common areas where practices struggle is deciding whether to bill under a Group NPI or an Individual NPI. Getting this wrong doesn’t just delay payments. It can trigger claim denials, compliance issues, and audit flags that hurt your bottom line. The National […]

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CMS-1500, Group NPI, Individual NPI, Medicaid, Medicaid Billing, Medicare, Medicare Billing, National Provider Identifier, NPI, NPPES, Private Insurance, Provider NPI, PTAN

PECOS 2.0: Medicare Enrollment Gets a Major Upgrade

November 20, 2025 / admin / Articles, Centers for Medicare & Medicaid Services, CMS, Medicare, Medicare Billing, Medicare Credentialing, Medicare Enrollment, Medicare In-Network, Medicare PECOS, Medicare Reimbursement, PECOS, PECOS 2.0
Female Medical Doctor PECOS User

The moment healthcare providers have been waiting for has arrived. After years of anticipation, CMS has officially launched PECOS 2.0, bringing a completely redesigned approach to Medicare enrollment and revalidation. This isn’t just a minor update to the old system, it’s a ground-up transformation that affects every aspect of how providers join and maintain their […]

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Centers for Medicare & Medicaid Services, CMS, Medicare, Medicare Billing, Medicare Credentialing, Medicare Enrollment, Medicare In-Network, Medicare PECOS, Medicare Reimbursement, PECOS, PECOS 2.0

Medicare Reimbursement: Understanding the Labyrinth

April 3, 2024 / admin / Articles, Geographical Practice Cost Index, Inpatient Prospective Payment System, IPPS, Medicare, Medicare Coverage, Medicare Reimbursement, Medicare Severity Diagnosis Related Groups, MS-DRG, OPPS, PPS, Prospective Payment Systems

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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APC, APCs, CMS, Geographical Practice Cost Index, Healthcare, Healthcare Billing, Inpatient Prospective Payment System, IPPS, Medical, Medical Billing, Medicare, Medicare Billing, Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, Medicare Physician Fee Schedule, Medicare Reimbursement, Medicare Severity Diagnosis Related Groups, MIPS, MS-DRG, OPPS, Prospective Payment Systems, Revenue Cycle, Revenue Cycle Management

What Does Medicare Cover for Home Healthcare?

February 9, 2022 / admin / Articles, Billing, Billing Revenue, Healthcare, Healthcare Billing, Healthcare Outcomes, Medicaid, Medical Billing, Medical Claims, Medical Providers, Medicare, Occupational Therapy, Physical Therapy, Speech Therapy
Home Healthcare Service (Medicare)

Home Health Services + Medicare What does Medicare Cover for Home Healthcare? If you’re looking for an answer to the question, “What does Medicare cover for home healthcare?”, you’ve probably typed it into a search engine and immediately closed the tab. The amount of information and the level of detail can quickly become confusing and […]

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Healthcare, Healthcare Services, Home Health Care, Home Health Services, Home Healthcare, Medicaid, Medicaid Billing, Medicaid Coverage, Medicare, Medicare Billing, Medicare Coverage

Common Cases of Medicare, Medicaid Fraud

December 8, 2021 / admin / Articles, False Claims Act, Fraud, Medicaid, Medicaid Fraud, Medicaid Fraud Examples, Medicare, Medicare Fraud, Medicare Fraud Examples, Phantom Billing, Unbundling, Upcoding
Medicare Fraud

Medicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It *These are examples of fraud as it relates to Medicare and Medicaid. Medical fraud is the intentional deception or misrepresentation of healthcare transactions by the provider for the sake of receiving unauthorized benefits or financial gain. Healthcare fraud is committed when a dishonest […]

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Billing Fraud, False Claims Act, Fraud, Medicaid, Medicaid Billing, Medicaid Fraud, Medicaid Fraud Examples, Medical Billing Fraud, Medicare, Medicare Billing, Medicare Fraud, Medicare Fraud Examples, Upcoding

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Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Home Health
  • Urgent Care
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • Primary Care
  • DME
  • Home Health
  • Urgent Care
  • Cardiology
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Speech Therapy
  • Genetic Testing
  • Geriatric Medicine
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Podiatry
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Recent Posts

  • Medical Billing Trends in 2026

    Emerging Medical Billing Trends in 2026

  • Group of Ethnically Diverse Medical Credentialers

    Get Credentialed with Medicaid

  • Healthcare Executive Discussing Credentialing Bottlenecks

    Credentialing Bottlenecks: How to Fix Slow Onboarding

  • White Male Doctor Talking to a Female Hispanic Woman

    Group NPI or Individual NPI: Which Fits Your Practice?

  • White Male Doctor Challenged by RCM

    How to Manage the 5 Biggest Challenges in RCM

  • Medical Credentialing with PacificSource

    A Guide to Provider Credentialing with PacificSource

  • Male Medical Providers in White Jackets in Need of Credentialing

    The Most Common Reasons for Credentialing Denials

  • HomeAlternative Payment ModelsHow 2026 E/M and Telehealth Rules are Changing How 2026 E/M and Telehealth Rules are Changing

    How 2026 E/M and Telehealth Rules are Changing

  • White Male Medical Doctor Needing Credentialing

    Professional and Peer References in Medical Credentialing

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