Medicaid Fraud Enforcement Has Entered a New Phase — and Providers Should Not Assume This Is Political Theater
Large-scale Medicaid fraud discussions followed a familiar pattern in American healthcare for a long time. There would be a headline,…
Category: Business View
Ghost Networks Were Once an Embarrassment. Now They’re Becoming a Liability.
By Elena Pak, Credentiaing Department, WCH For years, provider directories occupied a strange place in healthcare administration: everyone knew they…
Malpractice Risk Is Declining — But Don’t Let That Number Fool You
By Elena Pak, Credentialing Department, WCH The headline from the American Medical Association’s latest research report sounds reassuring: the share…
The Medicare Advantage Improvement Act of 2026: What Providers Need to Know — and Do Now
By Elena Pak, Credentialing Department, WCH A bipartisan group of lawmakers has introduced the Medicare Advantage Improvement Act of 2026…
The Structural Compliance Failure Behind Healthcare’s Preventable Losses
By Elizaveta Bannova, Billing Department, WCH; Educational Officer, AAPC
The IDR Battleground: When Insurers Lose in Court, Who Actually Gets Paid?
No Surprises Act · Independent Dispute Resolution · Provider Finance By Olga Khabinskay, Director of Operations, WCH Blue Cross just…
The Hidden Minefield in Your Medical Billing Contract
By Edita Petrosyan, Billing Department, WCH
Open Payments Pre-Publication Window Is Open: What Every Covered Provider Must Do Before May 15
Elizaveta Bannova, Billing Department, WCH The 45-day review period has started. Missing it won’t cost you money directly — but it may cost…
Payer CEOs Made Up to $61 Million in 2025 — While Providers Fought Denials, Delays, and Shrinking Margins
In 2025, many physician practices described the same financial reality in increasingly urgent terms: claims taking longer to adjudicate, prior…
No Surprises Act: What Has Changed for Providers — and Where the Real Risks Now Lie
The law designed to protect patients created a new arbitration economy. That same system is now drawing sustained attention from…