Communicating coverage complications with patients

Former Integrated Medical Services CEO Monique Delgado explained how practice leaders can build performance-based physician pay with physicians at the table and why the work starts with the practice's own finances.

Overhead ratio, days in A/R and the owner draw explain why a practice can collect more than last year and still come up short on payroll.

States are limiting AI in coverage decisions. How billing teams can cite the laws on appeal, and why self-funded plans fall outside them.

Most Medicaid improper payments trace to missing paperwork, not fraud. These nine checks close the gaps auditors keep finding.

Payers deny with AI while practices appeal by hand. Taya Gordon on retiring 30-day AR buckets, the benchmarks to watch and a quick downcoding check.

An IDR win isn't a check. Payers have 30 days to pay, courts won't force them to and CMS admits awards are slipping through.

A former congressman and hospital and medical school advocacy leaders outline which federal health programs could shift in a divided Washington.

Nearly half of Medicaid members aren't ready for Jan. 1 work rules. Our new handbook shows the front desk how to keep eligible patients covered.