Billing

The Medicare Advantage program, designed to provide seniors with an alternative to traditional Medicare, has faced persistent issues of overpayments and fraud for over a decade. Despite the numerous efforts by the Centers for Medicare & Medicaid Services (CMS) to address and rectify these

The recent decision by the Fifth Circuit Court of Appeals regarding the No Surprises Act (NSA) carries profound implications for how the Qualifying Payment Amount (QPA) is calculated. This intricate ruling touches not only the processes healthcare providers and insurers employ but also

A growing debate within the healthcare industry has centered on the Senate's proposal for site-neutral payments, championed by Senators Bill Cassidy and Maggie Hassan. At the heart of the proposal is an effort to standardize Medicare payment rates across different care settings, with the

Healthcare in today's rapidly evolving environment faces numerous challenges, from rising costs to the need for more personalized, effective treatments. The launch of Longitude Health, a collaborative initiative by four major nonprofit health systems, aims to address these issues head-on

Understanding and ensuring Medicare compliance is crucial for healthcare providers, yet the complexity of these regulations means that sometimes, even the most diligent professionals can overlook key rules. This article delves into various critical aspects of Medicare compliance, with a particular

The Revenue Cycle Management (RCM) market is experiencing a dynamic transformation. As healthcare systems become more intricate and financial operations increasingly complex, efficient revenue management is crucial. The RCM market, valued at USD 49.8 billion in 2023, is projected to reach USD 140.3