Payers

Sometimes CMS can unjustly revoke a provider's billing privileges. Here are a few examples.

Everyone should know about CMS' rule about repaying overpayments within 60 days. What about private payers?

Regardless of your political thoughts, no one knows what, when and how the ACA plans are going to play out. Make sure you're prepared.

Patients really want to be cared for. And it's important to realize that treating them is different than caring for them.

The term "value-based care" has been thrown around a lot. What does it mean to you and your practice?

What can practices learn from a recent ruling by the Supreme Court on the False Claims Act? An expert weighs in.

While employed physicians often cannot accept samples in their practice, this independent doctor can and does, to help his patients in need.

A pediatric roundtable at MGMA16 led to the realization that there's wisdom in identifying the industry forces that we cannot change.

CMS released a dashboard that revealed the amount of money spent by the agency on specific drugs. Maryland docs reject medical marijuana.

The 2017 Medicare Physician Fee Schedule (MPFS) Final Rule has been finalized and will take effect Jan. 1, 2017. Here's what you should know.

Is your practice ready for the new Medicare payment systems coming in January 2017? Now is the time to develop a plan.

Final Rule concessions under MACRA may just delay implementation of new payment model, and together CMS and Vermont create single, state-wide ACO.

Negotiating the rate increase you want from a payer is a "war of attrition," says one expert. Here are 10 ways they'll try to trip your practice up.

The Triple Aim has created immense pressure to integrate the care we provide into the larger healthcare system, at great cost to our practice.

Blue Cross Blue Shield is jumping ship, here's what you need to know, and how it might affect your practice.

In our recurring blog "Inbox" we share comments from physicians and practice administrators telling us what keeps them awake at night.

You've seen Trump vs Clinton. The Pearls podcast looks at another debate: Should the Affordable Care Act be repealed or not?

The Great American Physician Survey reveals that doctors find their profession more stressful and less lucrative than in the past.

As Anthem and Cigna aim to merge, reports say the two companies have been sniping at each other. Also, are fitness trackers effective in weight loss?

In our recurring blog "Inbox" we share comments from physicians and practice administrators telling us what keeps them awake at night.

In an era of delivery and payment reform, with an imbalance of costs and savings in care, there are complex challenges behind team-based care.

Scheduling well-child exams in our practice has become a study in complexity, as we try to accommodate both payers and parents.

Rising patient deductibles and cost sharing not only hurts patients, but also can put pressures on medical practices to manage their revenue cycle.

With so many clinical restrictions in healthcare right now, physicians and their medical expertise might just become redundant unless something is done.