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Articles by GetPractice Help
Revenue cycle management is more than medical billing
Ask an independent practice owner who handles the revenue cycle and the answer is usually the name of a billing company. Ask what that company actually does each month and the answer gets shorter. Claims go out. Payments get posted. Denials get worked. Statements get mailed. That is medical billing, and it is valuable work. It is not the same thing as managing the revenue cycle, and the space between the two is where many practices lose money without ever seeing it leave.
Credit balances in medical practices have a deadline
Most independent practices know their accounts receivable to the dollar. Far fewer can say what their credit balances total, how old the oldest one is, or who is supposed to be doing something about them. A credit balance sits in the practice management system as a negative number on a patient or payer account, it rarely triggers an alert, and it quietly inflates the bank balance the owner looks at every Friday. The money is real.
The revenue gap a physician notice period never closes
A resignation letter arrives with ninety days written on it. Most practices read that as ninety days to find a replacement, and the search starts that afternoon. What the letter actually started is three clocks running at once, and only one of them speeds up when the practice hires faster. The payer contracts have their own notice terms. The medical records have their own custody obligations.
How to manage patient records requests and reduce delay
A patient records request arrives the way a supply order does. It comes in by fax, portal message, or across the front desk, and joins a queue behind every task with a patient sitting in a room. Two federal rules attach the moment it arrives, each on a different clock, and neither is enforced by the practice management system. The result is a workflow most independent practices cannot describe in numbers. Not the median turnaround. Not the oldest open request. Not who owns the queue.
The credentialing gap is a cash problem, not a delay
Most new practices treat their projected open date as the point revenue starts. It is not. It is the point expenses start, in full, while revenue is still weeks or months away. Somewhere close to two in three new practices open their doors before they are enrolled with most of the commercial payers they plan to bill, which means the gap between opening and getting paid is not a rare planning failure. It is closer to the default outcome, and most startup budgets never price it as one.
MIPS reporting in 2026 is an operations problem first
Most independent practices treat the Merit-based Incentive Payment System (MIPS) as a clinical-quality program with a billing-side tax. That framing misreads the decision. MIPS participation is mostly an operational question: whether the practice has the data infrastructure, EHR capability, and vendor support to clear the performance threshold, and whether the dollar exposure of skipping is worse than the cost of compliance.
Run a payer panel audit before renewal season
Most independent practices renew payer contracts the same way they sign them: the renewal letter arrives, the practice manager forwards it to the physician owner, and either someone signs it or no one does. The contracts that escape renegotiation for three or four cycles are the ones quietly anchoring 20 to 35 percent of commercial volume at fee schedules that lag the practice’s best contract by 15 to 25 percent. The pattern we observe across practice sizes is consistent.
How to evaluate a practice management consultant
Most operational decisions in an independent medical or dental practice are made under time pressure with incomplete information. Hiring a practice management consultant is the decision practice owners turn to when they recognize that the operational gap exceeds their capacity to close. The mistake is not the decision to bring in outside help.
HIPAA compliance for small practices is not paperwork
Most independent practices treat HIPAA as a documentation exercise. The policy binder sits on a shelf, the privacy notice is posted, the staff training certificate is in the file, and the assumption is that the practice is covered. Enforcement patterns over the last several years suggest a different exposure model. The settlements that reach small practices are rarely about the policies that were missing on paper.
What an EHR migration actually costs in year one
Most physician owners consider switching EHR systems when frustration peaks. Support hold times have crossed an hour. Productivity has dropped enough that two providers are working late three nights a week. The system has felt wrong for at least eighteen months. The decision then forms around the frustration. A new vendor is researched, a demo is scheduled, and a migration is planned for the slow season. What rarely happens is the prior question.
Denial rate segmentation finds your real revenue leak
Slow collections in an independent practice are usually treated as a billing problem. The vendor gets called. The workflow gets reviewed. The staff gets reorganized. The denial rate gets a quick check and is reported as a single number for the month, something between 8 and 12 percent. That headline number, by itself, is the wrong metric.
1 in 12 medical billing companies just vanished
When an independent practice evaluates a billing company, the diligence usually concentrates on three questions: what it costs, how clean the claims are, and how fast someone answers the phone. Those are the right questions for choosing between vendors that exist. They say nothing about the scenario practices plan for least and recover from worst: The vendor stops existing. That scenario sounds like an edge case. The data says it is a base rate.
Why your overhead percentage is the wrong benchmark
In primary care, practice overhead is commonly described as 50 to 60 percent of collections. That range is repeated in continuing education, in vendor marketing, and in the operational frameworks new practice owners are handed when they ask what normal looks like. The range is not wrong. It is just too broad to be operationally useful. A primary care practice running at 58 percent overhead might be perfectly stable, undercompensating its physicians, or overspending on staff.
Why HIPAA settlements hit independent practices
Most independent practices treat HIPAA as a documentation exercise. The policy binder sits on a shelf, the privacy notice is posted, the staff training certificate is in the file, and the assumption is that the practice is covered. Enforcement patterns over the last several years suggest a different exposure model. The settlements that reach small practices are rarely about the policies that were missing on paper.
Payer contract renegotiation costs independent practices
A typical commercial payer contract for an independent practice gets signed once, usually under time pressure during credentialing, and then sits untouched for three to five years. The practice receives annual fee schedule updates from the payer, treats them as the new floor, and moves on. The contract is filed and rarely opened again.
How Medicare changes affect medical billing contracts
Policy changes eventually become operating decisions Most coverage of Medicare payment changes stops at reimbursement. A practice reads that a rule changes payment for certain services, then asks the obvious question: How much revenue is at risk? That question matters, but it is not the only operator question. Medicare practice expense and related Physician Fee Schedule changes also affect the billing-service decision.
3 reasons credentialing delays push past 90 days
The extra 90 days is not a rounding error A 90-day credentialing timeline and a 180-day credentialing timeline can sound like two versions of the same problem. They are not. The second version can mean another quarter of rent, software, malpractice coverage, staff time, loan payments, marketing spend, and owner compensation before the practice can bill a major payer.
Accounts receivable days hide four billing problems
A cash symptom can have several causes A practice owner notices the same warning signs: collections are lower than expected, the bank balance feels tighter, and the billing report shows money still sitting unpaid. The first conclusion is usually simple. Billing is the problem. Sometimes that is true. More often, the word “billing” is covering several different problems that require different fixes.
5 questions to ask before you choose a credentialing service
Credentialing mistakes are expensive before they are visible Credentialing problems usually look administrative until the revenue gap appears. A new practice may be open, staffed, leased, insured, and ready for patients, but one missing payer panel can cut off a revenue stream for a quarter or more. The timeline is not small. Payer enrollment commonly takes 90 to 180 days.
EHR vendor evaluation should happen before the demo
Most EHR demos are built around the same set of features: mobile access, AI-assisted documentation, integrated billing, patient portal design, and telehealth. Those features matter, but they do not prove the system will work in a real clinic day. The demo is a controlled environment. The vendor chooses the patient, the encounter, the documentation path, the billing example, and the person clicking through the screen.
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