One in Five Patients Denied Care: Why This Matters to Every Medical Practice
By Elena Pak, Credentialing Department, WCH A new survey from the Commonwealth Fund found that one in five privately insured Americans reported that they or a family member…
ACA Under Fire Again: Why Cities Are Suing Over New Marketplace Rules — and Why Providers Should Pay Attention
By Elena Pak, Credentialing Department, WCH A new legal challenge against federal Affordable Care Act (ACA) marketplace regulations may appear to be a political dispute. In reality, the…
The MultiPlan Litigation: Why Every Provider Should Be Paying Attention
For years, many physicians, hospitals, ambulatory surgery centers, and specialty practices have shared a common frustration: out-of-network reimbursements that seemed increasingly disconnected from the actual cost of care.…
Medical Necessity Under the Microscope: What a $6.73 Million DOJ Settlement Means for Procedural Practices
The Department of Justice recently announced that a California vascular practice and its owner physician agreed to pay more than $6.73 million to resolve allegations that medically unnecessary…
Surgical Coding: The Global Period Is Not Bureaucracy. It’s a Trap.
By Edita Petrosyan, Billing Department, WCH Why Physicians Lose Money Without Breaking a Single Rule Picture this: you performed a planned total knee arthroplasty (CPT 27447). Three weeks…
CAQH Is Rebuilding From the Ground Up — Here’s What Providers Need to Know
The credentialing platform most providers already use is undergoing its most significant overhaul in years. What’s changing, and what does it mean for your practice? If you’ve ever…
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