A new KFF analysis reveals that retrospective chart reviews are a primary driver of risk-adjusted payments for Medicare ...

By a News Reporter-Staff News Editor at Insurance Daily News-- Current study results on Managed Care have been published. According to news originating from New York City, New York, by NewsRx ...

A Senate health committee has sent the AMA another letter demanding details on how it maintains and licenses the CPT code set, building on a probe launched in October.

Endocrinologist Athena Philis-Tsimikas, MD, corporate vice president of the Scripps Whittier Diabetes Institute in San Diego, ...

Hospitals nationwide confront the Medicare Advantage question hospitals face on participation amid rising denials and reimbursement challenges.

Molina Healthcare may rebound after 2025, with profitability driven by sector premium hikes. See here for MOH's potential ...

Medicare overpaid for optometry services to nursing homes, the Office of Inspector General’s (OIG) audit report released Thursday found. In OIG's sample, ...

Senate Health, Education, Labor and Pensions (HELP) Committee Chair Bill Cassidy, M.D., is doubling down on his scrutiny of the American Medical Association's (AMA's) handling of billing and claims ...

WASHINGTON – Complex rehab technology (CRT) stakeholders were pleasantly surprised when CMS recently removed the ICD-10 requirements for skin protection and positioning cushions and backs. The Durable ...

Medical professionals and healthcare facilities must complete different forms when billing for the services they provide. These are not forms you need to complete yourself. Claim form CMS-1500 is for ...

The American Medical Association has released new medical codes for 2026 amid a growing debate about whether the medical group may have too much influence over the healthcare coding system. The AMA ...

In 2025, the Social Security Administration (SSA) notified people in over 850,000 zip codes about Medicare programs that may help them with their medical expenses. Many people with incomes below ...