All the change in healthcare over the recent years has unfortunately meant new opportunities for abuses of medical billing. This kind of fraud and misuse puts providers at risk financially and ultimately jeopardizes the quality of care you can provide in the long term. Many providers who have realized this understand that now is a good time to consider investing in medical coding audits. If you begin the process now,
Why Medicare Advantage Plans and ACOs Need Experienced Vendors to Prepare for CMS-HCC Version 28
Medicare Advantage (MA) plans and Accountable Care Organizations (ACOs) should be reevaluating their vendor strategy in light of coming changes.
This is largely because of a new version of the Hierarchical Condition Category (CMS-HCC) risk adjustment model that CMS released in 2023. It includes changes that will enhance the value of partnering with an experienced vendor for in-depth retrospective and concurrent risk adjustment reviews. Leaders at these organizations will benefit from
Medical Billing Predictions for 2024: The Weather is Finally Changing
Medical providers should be doing everything they can to get in front of the medical billing changes that are coming next year – and this starts with understanding what’s in the forecast
The Helping Kids Cope Act Means a Fresh Look at Pediatric Billing and Working with Pediatric Medical Billing Companies
Finding new opportunities for pediatric billing is critical to maintaining the health of pediatric medical practices, and new legislation might be a change that aligns with the health of the children and families you care for. As you review the act, look for
What the Texas Itemized Bill Law Means for Physician Billing Services
“As goes Texas, so goes the nation”. This saying is something anyone responsible for physician billing services should keep in mind when considering the impact of the Texas Medical Billing law. While the bill targets “healthcare facilities”, providers at all levels should pay attention – this type of legislation signals a shift in demands around the patient experience,






