Billing and Claims

New findings suggest upcoding is becoming a more common practice in emergency departments, urgent care centers, and physician offices. 

When organizations receive a charge denial from a commercial payer, they must weigh their options to determine whether challenging the decision wil

The Office of Inspector General (OIG) highlighted several congressional actions that, if taken, could lead to $17 billion in potential cost savings across HHS programs.

Gain insights into CMS’ and the Office of Inspector General’s audit targets and learn how to put this knowledge to work at your organization.

When first learning about modifier -25, revenue integrity professionals were likely given an example of a patient in a physician office being evalu

CMS is proposing a 2.4% increase in operating payments for acute care hospitals and weighing numerous modifications to quality and reporting programs tied to reimbursement.