Payers

Medicaid work requirements, new remote monitoring rules and an electronic prior authorization deadline all land Jan. 1, and that's only part of what MGMA told practice leaders to watch.

Hold times, delayed approvals and denials on authorized care dominated member feedback to MGMA's government affairs team.

MGMA is pushing back on any delay as insurers describe a three-step build.

A delay would leave practices without the information they need to train staff and test workflows before the deadline, the AMA told CMS.

One line in a payer contract just cut 40% of a Hawaii clinic's panel.

As House lawmakers take up MACRA, MGMA backs three bills to tie payments to inflation, raise budget neutrality and replace MIPS scoring.

A new AMA survey scores the country's largest commercial insurers on the prior authorization burden they impose on physician practices.

Auto-renewal clauses, stale fee schedules and unread terms quietly erode revenue; these eight questions surface what to fix before renewal.

Independent practices can win payer negotiations, but preparation is everything. Doral Jacobsen of Prosper Beyond VBC explains how.

The 2026 Payer Scorecard shows practices face low reimbursement and soaring prior auth and denials, while payer service lags, squeezing revenue cycles.

With ACA premiums set to spike in 2026 and patients facing dramatically higher out-of-pocket costs, here are five strategies providers can implement now to protect revenue, improve collections and stay ahead of the coming financial storm.

These negotiation strategies ensure fair contracts and improved revenue for medical practices.

The Medical Group Management Association (MGMA) is backing the bipartisan Safe Step Act (H.R. 5509), legislation that would reform step-therapy requirements and ease prior authorization burdens on medical practices.

These six effective strategies to streamline revenue cycles, reduce accounts-receivable days and enhance efficiency in independent medical practices.

Physicians navigate challenging payer negotiations, sharing success stories of securing approvals for innovative, cost-effective treatments.

Step therapy protocols not only delays necessary treatment but can lead to adverse reactions that ultimately increase rather than lower health care costs.

What payers need to do to improve relationships with practices.

The verdict is in for how practice's feel about their payers, and it isn't good.

The crux of payer-provider collaboration lies in alignment.

Consider the puffer fish

Here are 11 ways you can, and should, engage in grassroots advocacy for your practice, your patients and yourself.

It’s clear the state of PA must change. Artificial intelligence has a role in streamlining administrative tasks.

Negotiating your payer contracts is the ticket to the money you deserve.

Payers are seeking to eliminate payments for care they deem unnecessary.

These tips can make your next payer negotiation a bit more of a breeze.