The Practice Layer

Every new physician hire comes with a hidden countdown. The gap between their start date and payer enrollment isn't just an inconvenience. It's a six-figure revenue leak that most practices don't calculate until it's too late. This week we break down the real math behind credentialing delays and what the smartest practices are doing 4-6 months before day one.

This week on the Practice Layer, The $9 fee that costs you $15,000, iPLEDGE loosens up, AI scribes in derm, and Scripps' MA exit pays off.

This week on the Practice Layer, BCBS Michigan cuts modifier 25 payments in half, CMS finally comes for MA overpayments, and the 4 upstream metrics that actually predict your cash flow.

This week on the Practice Layer, The OIG reviewed modifier 25 claims and found 90% compliance. Sounds like a win. It's not. We break down what $62.9M in errors means for your practice, why BCBSM is cutting reimbursement 50%, and the self-audit you should run today.

This week on the Practice Layer, we're unpacking the biggest reimbursement story in dermatology: skin substitute payments just collapsed from $2,000 to $127 per square centimeter. Plus, prior auth reform is picking up steam in Missouri and beyond, False Claims settlements hit a record $6.8 billion, and why basic automation is outperforming generative AI.