We don't need to keep up with our kids' changing lingo. Listening to the concerns, emotions, and desires that underlie the ...
Prior authorization, Medicare Advantage requirements and quality reporting are among the leading drivers of practices’ ...
The Medical Group Management Association (MGMA) today released its 2026 Regulatory Burden Report, highlighting how escalating federal regulatory and administrative requirements are overwhelming ...
The health system claims the policy, which reduces reimbursement for some inpatient hospital stays, violates federal law and ...
A Pennsylvania health system filed suit this week against Aetna, challenging a policy around "downcoding" that has drawn ire ...
Maryland regulators fined Cigna Health and Life Insurance Company $80,000 and ordered it to stop reducing payments on certain doctor-billed services — a practice that could leave patients on the hook ...
An Illinois Senate bill introduced in February would ban payers from using automated tools, including AI, to downcode physician claims and would require that any downcoding decision be made by a ...
SPRINGFIELD, Ill. (WAND) — The Illinois Senate Insurance Committee unanimously approved a bill to prohibit insurance companies from using artificial intelligence to code a health service lower than ...
"Al-driven denial engines, downcoding & modifier stripping are quietly eroding 6-9% of collectible revenue - below routine audit detection." Medical Billers and Coders (MBC), a Revenue Integrity ...
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