American Transit alleges it was defrauded of at least $3,360,566.83. Under federal racketeering law, the insurer can seek triple that amount - and it has, pegging its claim at $9,786,487.20. The ...

The federal government’s newest price transparency rule is written for payers, but its effects could reach ASCs well before the first revised rate files post in 2027. CMS and the Labor and Treasury ...

BCBS claims that bump coding has become more widespread because hospitals are using AI tools to identify secondary diagnoses. Automated tools can skim a patient’s chart and prompt physicians to ...

Therapists often finish sessions with documentation still waiting, while claims, eligibility checks, and payment updates require separate attention. A therapist-focused EHR connects clinical notes ...

Multi-physician gastroenterology practices lose $140,000 to $220,000 a year to billing errors, according to medical billing company ProMBS. The company says the losses come mostly from miscoding, not ...

An AHA blog published today responds to a Blue Cross Blue Shield Association report suggesting that hospitals’ use of artificial intelligence-enabled documentation tools is driving higher healthcare ...

Fraud, waste, and abuse (FWA) continue to challenge dental plans as overtreatment, miscoding and inappropriate billing ...