Insights

Ideas, insights + industry updates

4 Tips for Forming an Employee Advisory Group

Creating and effectively overseeing an EAG is can have a significantly positive impact on employee engagement, morale and company culture. … Read More

February 27, 2023

3 Tips to Successfully Negotiate Your Next Payer Contract

Providers must leverage what’s in their payer contract, comparative data and price transparency rules to level the playing field with payers. … Read More

February 27, 2023

Diagnostic Monitoring Services Under Increased Federal Scrutiny Following $45M Settlement

A cardiac monitoring company and its subsidiary agreed to a settlement with the DOJ following allegations they violated the False Claims Act. … Read More

February 24, 2023

CMS Proposes Updates to Medicare Advantage Utilization Management Policies + Overpayment Standards: Comments Due Feb. 13

CMS issued a proposed rule that could change utilization management and prior authorization criteria for Medicare Advantage plans. … Read More

January 30, 2023

Be Prepared for Increased Medicare Bad Debt Compliance Scrutiny

OIG and CMS agree more scrutiny is needed for Medicare bad debt reimbursement and encourage more regular review of bad debts claimed. … Read More

January 28, 2023

3 Ways to Dramatically Reduce Denials

With financial pressures increasing, providers can’t afford not to implement effective denial management and prevention strategies. … Read More

January 28, 2023

OIG Advisory Opinion: Providing Nurse Practitioner Services for Referring Physicians Poses Minimal Anti-Kickback Risk

The OIG issued an Advisory Opinion on nurse practitioners providing services that are traditionally performed by primary care physicians. … Read More

January 25, 2023

Beyond the Payment Variance Report

Experts share common issues that lead to costly underpayments as well as effective resolution strategies leveraged across 200+ hospitals nationwide. … Read More

January 10, 2023