When the Algorithm Becomes the Adjuster: Senate Scrutiny of AI in Medicare Advantage Denials
By Elena Pak, Credentialing Department, WCH Two senators just gave three of the country’s largest health insurers two weeks to…
Category: Business View
Follow the Money: Inside HHS’s Six-Month Fraud Enforcement Scorecard
By Elena Pak, Credentialing Department, WCH The federal government’s semiannual report card on healthcare fraud just landed, and the numbers…
UnitedHealth’s Home-Visit Audit Clears a Low Bar, Not a High One
UnitedHealth got the headline it wanted this month: an outside audit of its HouseCalls program found that the overwhelming majority…
The Physician Employment Contract Isn’t Fixed. Most Doctors Just Treat It That Way
Ask most physicians how they approached their current employment contract, and a common answer is that they read it once,…
She Wrote the Compliance Book. Then She Ran a $136M Fraud Scheme.
There is a sentence in the DOJ’s press release about Jean Wilson that deserves to be read twice. After her…
$5.7 Trillion and Climbing: What America’s Health Spending Surge Actually Signals
The number itself is almost too large to process. U.S. healthcare spending reached $5.7 trillion in 2025 — a 7.3%…
When Your Provider Is Abroad: The Hidden Compliance Trap in Cross-Border Telehealth
By Elena Pak, Credentialing Department, WCH Telehealth has made geography feel irrelevant. A physician in Portugal, a therapist in Thailand,…
Criminalizing Coverage Denials?
What Pennsylvania’s New Bill Reveals About the Growing Backlash Against Health Insurers By Elena Pak, Credentialing Department, WCH When Pennsylvania…