Claims Processing

A recent analysis of Pennsylvania hospital revenues points to an overall increase in total net income for the state’s hospitals, but officials at a statewide hospital advocacy group suggest those numbers don’t take into account longer term financial trends.

"Reform" of the U.S. healthcare system can mean a myriad of things, all of which have been discussed and debated ad nauseum over the past two years - before, during and after passage of the Affordable Care Act.

There has never been a more critical time for U.S. healthcare providers to ensure they follow best practice guidelines when it comes to billing and payment.

There are some who argue that human beings are violent by nature.

A new Medicare Trustees Report has projected that Medicare's Hospital Insurance Fund will run out of money in 2024, five years earlier than projected in last year's report.

A recent survey of employers shows more than half would like to improve their employees' health habits as a means of reining in the rising cost of providing health benefits.

Should brokers be compensated for helping consumers to enroll in government programs like the Pre-Existing Condition Insurance Plan (PCIP) created by the new healthcare reform law? Until now, the federal government’s answer has been “no.”

With six months to go before the HIPAA 5010 electronic claims submissions compliance date, the Centers for Medicare and Medicaid Services have announced two 5010 national testing days.

Anthem Blue Cross and APS Healthcare have announced an agreement that will see APS provide targeted care management and coordination of Anthem members enrolled in Medi-Cal's California's Seniors and People with Disabilities (SPD) Program.

A patient recruiter for a Houston-based durable medical equipment company is the latest to be convicted in court for a scheme in which Medicare was billed for wheelchairs supposedly damaged in a hurricane.