Congress should enact legislation to require the Centers for Medicare and Medicaid Services to evaluate transitioning to a single modern procedure coding system to eliminate excess costs and lower ...

Medicaid managed care policy shifts scheduled for 2026 are poised to affect how home care agencies process and submit claims significantly. New compliance benchmarks, reporting expectations, and data ...

Ron Brank, a group vice president for Symbion in Nashville, Tenn., offers 10 points on using cost data for managed care contract negotiations. 1. Meaningful data is essential. In managed care contract ...

On April 22, the HHS Centers for Medicare and Medicaid Services (CMS) published a long-awaited final rule regulating the use of managed care in Medicaid and CHIP. The official Federal Register version ...

Contract negotiations adhere to a rule that 80 percent of time should be used to prepare for the negotiation and 20 percent to negotiate. To help be more effective in achieving results when you ...

The doctors’ association is blowing up the U.S.’ decades-old coding system for recording pregnancy services and starting fresh next year, bowing to calls from OB-GYNs and other maternity specialists.

Workforce shortages, regulatory complexities and economic challenges have put hospitals and health systems under immense pressure to improve operational efficiency, accelerate payments and reduce ...

Care Qventus launches gap and coding automation suite to improve patient care and increase reimbursement accuracy in real time.

Coding of physician office visits can be very confusing – and is ever-changing. Every year, regulations and guidelines change, and it is difficult for providers to keep up. Most groups have coding ...