Billing and reimbursement

A recent report from Waystar provides a step-by-step strategic plan to help you achieve clarity in claim management processes

Like previous federal government shutdowns, the one that ensued when Congress failed to produce a continuing resolution on the budget by October 1 has implications for providers. You should reduce the chances of harm by planning to address them now.

CMS recently clarified billing and coding requirements for critical care scenarios, hospital outpatient clinic visits, telehealth, and other evaluation and management (E/M) services.

Analyze common coding and documentation mistakes that organizations make when submitting skin substitute claims. 

Q: What is the purpose of hospital mortality reviews, and how are they calculated?

CMS recently published two proposed rules to spell out potential payment updates and policy changes for outpatient and physician services.

Download a recent report from Waystar to get exclusive feedback from revenue cycle leaders on their top investment priorities and strategic focus areas for 2025.

With risk adjustment’s impact on reimbursement, review tips for accurate coding, compliant documentation, and timely responses.

Learn how CMS plans to enhance its risk adjustment data validation auditing efforts for Medicare Advantage (MA) plans and recover overpayments.

CMS is seeking feedback on potential policy changes ahead of the third cycle of negotiations under the Medicare Drug Price Negotiation Program.