Risk Adjustment Solutions for 2027: Moving fr...
Risk adjustment solutions for Medicare Advantage organizations are entering 2027 under a confirmed payment environment and a set of operational changes that require adaptation before January 1. CMS's April 2026 Rate Announcement projects MA payments to increase by 2.48% – over $13 billion – in CY 2027, while CMS expects MA risk scores to increase by 2.50% on average due to underlying coding trends [1]
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September 15, 2026
FQHC Billing and Reimbursement: What ...
FQHC billing services in 2026 are operating under a materially updated payment and coding environment – one that affects...
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September 04, 2026
Could HCC Risk Adjustment Have Preven...
HCC risk adjustment became the center of a $14.1 million Department of Justice settlement on August 3, 2026, when Comple...
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July 22, 2026
The 2026 Medicare Physician Fee Sched...
CMS finalized the 2026 Medicare Physician Fee Schedule (MPFS) in October 2025, with policies effective January 1, 2026. ...
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May 22, 2026
Why Your 99214 Keeps Becoming a 99213...
You’re leaving $25-$40 per visit on the table every time a legitimate 99214 gets downcoded to 99213. Not because someone...
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October 29, 2025
Can Urine Toxicology Lab Services Be ...
With telehealth now a mainstream mode of care, many pathology labs, clinical laboratories, and behavioral health provide...
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September 19, 2025
7 Best Practices for Medical Billing ...
If you’re a U.S. healthcare provider searching for medical billing and coding services, you’re not alone. Thousands of p...
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June 20, 2025
AAP Releases 2025 Pediatric Billing G...
A healthy patient financial experience is critical for pediatric providers. Errors in pediatric billing, coding or docum...
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May 23, 2025
Outsourced Medical Billing in 2025: A...
The medical billing outsourcing market is experiencing unprecedented growth, with the global market size projected to re...
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September 17, 2024
7 Things to Know About Medicaid Manag...
At more than 90 million people, Medicaid sits near the top of the list of the United States’ largest insurers. It covers...
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