Whistleblower Program Incentivizes Reporting of Healthcare Fraud
A new corporate whistleblower program incentivizes reporting of healthcare fraud involving private insurance plans. … Read More
A new corporate whistleblower program incentivizes reporting of healthcare fraud involving private insurance plans. … Read More
Many bills have been pending in state legislatures. Let’s take a look at what’s been recently enacted in three of those states. … Read More
State legislatures have already been busy this year. Here are some topics and bills Ensemble experts have been watching closely. … Read More
Health plans will be required to meet a prior authorization time frame as short as 72 hours, along with providing reasoning for any denials. … Read More
See how Ensemble is actually applying AI to drive value across the entire revenue cycle. … Read More
Federal agencies are scrutinizing Medicare Advantage coding with inaccurate diagnoses for enrollees with certain high-risk diagnoses. … Read More
The 2024 Medicare Advantage Final Rule clarifies that Medicare Advantage (MA) plans must follow the Two-Midnight Rule set in 2013, and more. … Read More
A report from the OIG found some MCOs have unusually high rates of prior authorization denials, with limited or no state oversight. … Read More
This new rule introduces several key changes that will promote transparency and consistency in healthcare coverage decisions. … Read More
Cigna added to the list of codes to be denied if billed without a corresponding CPT or HCPCS code starting May 1, 2023. … Read More
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