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Claims Processing

By Chelsey Ledue | 11:57 am | December 17, 2010
The Department of Veterans Affairs has announced it will begin using Medicare's standard payment rates for certain medical procedures performed by non-VA providers on Feb. 16, 2011.
By Diana Manos | 12:13 pm | December 15, 2010
In a new sample audit of Medicaid payments, the Office of the Inspector General found the government "inappropriately paid" 6.5 million claims for a total of $724 million. The claims were for personal care service provided by attendants who didn't have proof of federally required qualifications.
By Richard Pizzi | 12:02 pm | December 08, 2010
Underwriting discipline and an improved cost structure have led to an increased credit rating for Blue Cross Blue Shield of Nebraska.
By Carol Spencer | 11:37 am | December 08, 2010
In order to remain in compliance with Medicare rules, and avoid denials by recovery audit contractors (RACs) and others, hospitals must reduce outpatient procedures performed during inpatient stays.
By Richard Pizzi | 11:46 am | December 07, 2010
The Centers for Medicare & Medicaid Services has posted the 2011 Medicare clinical laboratory fee schedule files on its website.
By Eric Wicklund | 10:39 am | December 07, 2010
Siemens Healthcare clients looking to upgrade their legacy patient accounting systems will have help switching to the company's revenue cycle management platform, thanks to a new partnership with Cymetrix.
By Eric Wicklund | 09:10 am | December 03, 2010
A new partnership between two healthcare information technology companies will allow patients registering for medical appointments on wireless touchscreen devices to pay for them as well.
By Ernie De Los Santos | 01:53 pm | November 30, 2010
The RACs officially rescinded some reviews in the past few weeks, even after having completed complex reviews including the issuance of denial letters to the providers for the claims reviewed.
By Molly Merrill | 10:57 am | November 30, 2010
A pilot program being conducted by the Department of Veterans Affairs is testing whether using a private contractor to collect healthcare records from private physicians can speed the processing of veterans' disability compensation claims.
By Chelsey Ledue | 11:53 am | November 19, 2010
The owner of a Miami-area HIV clinic has been sentenced to almost six years in prison for his part in a Medicare fraud scheme.