Insights
Notes on reimbursement, audits, coding, and the rules that move a healthcare revenue cycle.
August 8, 2025
In a significant development in the ongoing battle against healthcare fraud, Forefront Dermatology S.C. and Henghold Surgery Center LLC have agreed to pay a combined $847,394 to resolve…
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August 8, 2025
In a significant healthcare enforcement development, Premier Dental Holdings, Inc., doing business as Sonrava Health, along with several affiliated dental management and service organizations,…
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July 16, 2025
Discover how to overturn insurance denials with winning appeal strategies at the DENIAL$ TO DOLLARS: WRITING A WINNING APPEAL® event. Learn from well-known reimbursement attorney Joe Rivet, Esq.,…
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July 15, 2025
Learn how to write a strong physician medical claim appeal letter that improves reimbursement success. Discover key elements, expert tips, and must-include details. Denied medical claims cost…
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July 14, 2025
The Centers for Medicare & Medicaid Services (CMS) has released the highly anticipated CY 2026 Medicare Physician Fee Schedule (MPFS) proposed rule. This sweeping proposal, spanning over 1,800…
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July 12, 2025
The Centers for Medicare & Medicaid Services (CMS) has released the CY 2026 Medicare Physician Fee Schedule (MPFS) proposed rule, and it’s packed with telehealth policy updates that reflect the…
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July 10, 2025
Announcement of the DOJ-HHS False Claims Act Working Group to combat healthcare fraud and abuse through enhanced collaboration between the Department of Justice and Department of Health and Human…
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July 9, 2025
Dr. Sophie Toya, 56, of Bloomfield Hills, Michigan, was sentenced to four years in prison for a $6.3 million Medicare fraud scheme involving unnecessary orthotic braces prescribed to elderly and…
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July 1, 2025
Kenia Valle Boza, a certified coder who worked at Pasteur Medical Center and later HealthSun Health Plans, allegedly participated in a scheme to fraudulently increase Medicare payments by: Falsely…
Read articleThis page is educational. It is not legal advice and does not create an attorney-client relationship. Facts, contracts, and appeal windows control the next step.
