- Community Hospitals
- Health Plans
Red Flag Ruling a Victory for Physicians, AMA Says
The American Medical Association is applauding a federal appeals court's ruling that physicians who bill patients after...
Web Exclusive: $3.2B Lawsuit Targets Medicare Underpayments
A class action suit filed by seven California counties and physicians aims to force the Department of Health and Human...
Inpatient or outpatient? The battle to control costs
One of the biggest challenges in healthcare is controlling costs. A primary way to accomplish that is...
Top 6 Financial Game Changers for Hospitals
It's been a challenging year for healthcare executives with fiduciary responsibilities. Legislative reform, rising...
Web Exclusive: OIG: Medicare Contractor Overpaid $39.2 Million for Diabetic's Supplies
An audit by the Office of Inspector General finds deficient claims by NHIC Corp, one of four regional Medicare...
HP snags $200M Medicare claims contract
Palo Alto, CA-based HP Enterprise Services has been awarded a $200 million contract for Medicare Part B claims...
Web Exclusive: Inpatient Admissions Decision Fuels RAC Uncertainty
The approval of a Region C Recovery Audit Contractor issue for inpatient hospital claims review has initiated...
Magazine: Mayo's Medicare Move
A limited pilot program in Arizona asks patients to pay out of pocket.
Medicare-payment fix weighed
As leaders in Congress and the Obama administration look to expand health-insurance coverage while controlling costs...
Medicare pays, even if providers do not
Healthcare providers are allowed to collect millions of dollars in federal Medicare payments each year despite owing...
Medicare Boot Camp - Long-Term Care Version
Topics covered during this intensive, four-day course include Medicare coverage, billing, coding and payment for long...
Book: The New Era of Healthcare: Practical Strategies for Providers and Payers
This book focuses on methods to forge a partnership between healthcare providers and managed care payers. It contains...
Book: The How-To Manual for Rehab Documentation, Third Edition
Since our last edition, there have been significant changes to the rules and regulations surrounding documentation in...
Book: Healthcare Price, Cost & Utilization Benchmarks, Volume VI
Whether you are a healthcare provider or a managed care organization, up-to-date benchmarks are critical to successful...
Book: CMS Publication 100-4 Chapter 10: CMS Home Health Billing Manual
This handy manual, updated to reflect 2010 changes, is a great resource for finding answers quickly and easily when...
Audio Conference: Utilization Review and the Proper Use of Condition Code 44 and W2