Alleged Abuse of the No Surprises Act IDR Process – Providers and Billing Companies Be Warned
What a new federal lawsuit says about the growing strain on No Surprises Act arbitration—and [...]
Insurance Verification – It’s More than Scanning an Insurance Card
Verification gaps cause more denials than coding errors. Here are 3 ways to close them [...]
From Medical Biller to Imposter Provider: Federal Indictment Exposes Insider Healthcare Fraud
The healthcare system depends on trust—trust that professionals are who they say they are, that patient [...]
LCDs for Certain Skin Substitutes Withdrawn
Effective immediately, CMS’ A/B Medicare Administrative Contractors (MACs) are withdrawing the Local Coverage Determinations (LCDs) for Skin [...]
Denial$ to Dollars: Writing a Winning Appeal® (Virtual Event)
We have brought this sought-after workshop online, which has been in high demand. To keep the [...]
WISeR Model Launches January 1, 2026: What Medicare Providers Need to Know
Implementation of the Wasteful and Inappropriate Service Reduction (WISeR) Model, which tests using enhanced technologies including [...]
Billing Update: G2211 Now Payable With Home & Residence E/M Visits in CY 2026
CMS is continuing its effort to better pay for the complexity of longitudinal care by [...]
Urgent Care Operator Settles FCA Allegations for $3 Million
Bloom Care LLC, which operated urgent care clinics across Idaho and New Mexico during the [...]
Aug
New Cigna Policy Could Downgrade Your Claims — Without Warning
Starting October 1, 2025, Cigna Healthcare® will implement a sweeping new reimbursement policy that could [...]
Aug
6th Circuit Rules Against Hospitals in Key Case on Emergency Care Reimbursement: What AMISUB v. Cigna Means for Out-of-Network Claims
In a significant ruling for the healthcare and insurance industries, the U.S. Court of Appeals [...]
Aug