Claims Processing

One of California's largest health systems is paying $46 million to settle allegations of overcharging payers with obscured anesthesia billing practices. The state's insurance commissioner calls the agreement "groundbreaking."

In the revenue cycle management market, hospitals show high adoption of technology focused on eligibility and scheduling, with much work left to be done around charity screening and propensity to pay, according to a new report from HIMSS Analytics.

Improving care and lowering costs for beneficiaries eligible for both Medicare and Medicaid is the holy grail of the government and health plans alike.

For the most part, the largest U.S. healthcare providers have been very organized and prepared for ICD-10 implementation. Is there anything we can learn from their experience?

S&P Dow Jones Indices has launched a new indicator that measures claims data from 33 health insurance companies and other organizations to calculate the growth in commercial healthcare costs.

The ICD-10 transition is a wonderful opportunity for collaboration. More accurately, collaboration is a necessity.

The growth rate of healthcare spending rose 4 percent in 2012, slightly lower than the previous year, but with more dollars spent on outpatient care and out-of-pocket expenses, according to the Health Care Cost Institute.

Managing denials is a challenging prospect for providers, but experts say there are steps to make the process more efficient and more likely to be successful.

The Centers for Medicare & Medicaid Services issued a final rule on Medicaid payments to disproportionate share hospitals last week, cutting approximately $1.1 billion from the program over the next two fiscal years.

A recently unsealed lawsuit alleges that Vanderbilt Medical Center has been systematically billing Medicare fraudulent charges for at least a decade.