Surprise billing defined

A review of 1,536 patient inquiries found those answered within five minutes booked at more than three times the rate of those waiting over a day.

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.

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.

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.

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.

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.