Reimbursement
The audit, for years 2011 and 2012, covered $48 million in Medicare payments to the hospital for 7,506 claims potentially at risk for billing errors.
It's turning out to be a problematic year for health insurance IT management. Another Blue Cross insurer company has been hacked, and this time it seems that subscriber medical information was exposed.
Facing scrutiny over executive compensation, reserves and premiums, California's third largest insurer is under pressure to justify its state tax exemption, and state finance authorities wants to start collecting.
In its annual recommendations to Congress on Medicare policies, the Medicare Payment Advisory Commission recommends a 3.25 percent update to inpatient and outpatient hospital payment rates for 2016, as well as repeal of the Sustainable Growth Rate (SGR) methodology for physician services.
In a new customer experience survey, health insurers are just above the bottom, perhaps in part because the nature of the service and the industry's legacy. But some still came ahead with positive reviews.
A total of 16.4 million non-elderly adults have gained health insurance coverage since the Affordable Care Act became law five years ago this month, a "historic" reduction in the number of uninsured.
The nation's largest insurer may be setting a precedent with restrictions on a risky, though recently popular approach to the most common gynecological surgical procedure.
Clinics allegedly sought reimbursement for injection treatments, physical therapy treatments and other medical items and services not ordered by doctors.
The Next Generation ACO Model will test whether strong financial incentives, coupled with tools to help facilitate better patient engagement and care management, can improve health outcomes and reduce expenditures for Medicare beneficiaries.
In his new book, America's Bitter Pill, Steven Brill dives deep into the history of the Affordable Care Act (ACA) and how it was passed. He concludes that, although providing more Americans with health insurance is worthy of praise, the ACA does far too little to address the costs of health care.