Medicare Participation for 2027: What Practices Should Review Before December 31
Once a year, practices that bill Medicare get a chance to revisit a decision that is easy to forget. From mid-November through December 31, providers can decide whether…
The January 2027 Prior Authorization API Deadline: What Practices Need to Test Now
January 1, 2027 is a little over nine weeks away. A number of summaries describe it as a deadline for practices. For the most part, it is a…
The Payer Says “Network Closed.” Should Your Practice Stop Applying?
The letter arrives after weeks of waiting. The payer’s network, it says, is closed in your area. Many credentialing teams read that as a final answer, log it,…
Quest Restores Quanum LSM After Cyber Incident: What Medical Practices Should Check Now
On October 26, Quest Diagnostics reported that it had remediated a cybersecurity incident and restored Quanum Lab Services Manager (LSM), the online system some healthcare providers use to…
The $72 Million Screening Gap: Why Medicare Provider Checks Need More Than One Database
A provider’s Medicare enrollment status can change. An organization’s ownership can raise questions about its eligibility for payment. And a screening process that was accurate when a provider…
The $1 Billion Medicare Fraud Case: What Billing Teams Should Check Before Submitting a Claim
A physician’s order may be signed, complete and ready to enter into a billing system. That does not, by itself, establish that the ordered equipment was medically necessary…
Medicare Appeals in 2027: When Is a Denial Worth Taking Further?
Every billing office has a stack of denials that sit in a gray zone: too large to write off without a second look, too small to justify weeks…
Virtual Medical Assistants: A Cheaper Front Desk or a New Operational Risk?
The usual way to pose this question is to compare a salary with a monthly vendor invoice. That comparison is easy to make and almost always incomplete. A…
Your Next Patient May Choose Another Practice Before You Reply
A patient with a toothache or a knee that has stopped cooperating rarely contacts only one practice. They fill out a form at 8:40 p.m., open two more…
When the Business of Medicine Starts Competing With Patient Care
When a physician’s recommendation sends a patient outside the system, the decision can have consequences beyond the clinical encounter. A new survey raises questions about who sets the…
Maternity Wards Are Closing Across America. What Happens to the Next Generation?
When a hospital stops delivering babies, its doors may stay open. For families nearby, an essential part of the healthcare system is gone. A hospital can keep its…
Loneliness May Be Stealing Your Healthy Years. And a Busy Life Won’t Necessarily Protect You.
You can spend the day with patients, messages and meetings and still feel that nobody knows how you are doing. New research suggests that the gap between having…
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