A single ICD-10 code, a missing modifier or a misclassified procedure intent can shift a colonoscopy from a fully covered preventive service to a medically necessary diagnostic one, which could change ...
Billing management sits at the center of how healthcare organizations sustain themselves financially. It's not the most visible part of running a practice, but it's one of the most consequential. A ...
On June 23, 2026, the Department of Justice announced the 2026 National Health Care Fraud Takedown, which it described as the ...
A law meant to end surprise medical billing has led to large paydays for some surgical assistants, who can earn far more than ...
The mid-revenue cycle is where medicine, documentation, and coding converge to produce the record that determines reimbursement, risk adjustment metrics, and quality scores. Physicians make the ...
A new CMS proposed rule would reduce the burden of prior authorizations by further shortening payer decision timeframes and ...
The Trump administration is closing a loophole that drugmakers could use to avoid negotiations when they add active ...
Nebraska Methodist CFO Jeff Francis details the biggest shifts in revenue cycle, focusing on denials, AI use, and documentation improvements.
The Centers for Medicare & Medicaid Services July 2 issued a proposed rule that would increase Medicare hospital outpatient ...
An analysis of the June 2026 final rulemaking that updated the federal independent dispute resolution (IDR) process, the ...
AMA recently reiterated its call for Congress to pass several reforms that would increase physician payment and improve ...
Medicare’s new GLP-1 bridge program will provide eligible Part D prescription plan enrollees inexpensive monthly copays for ...
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