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…
Category: Business View
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…
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,…
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…
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…
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…
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…
The Autism Therapy Boom: Who Is Really Paying the Price?
ABA spending is rising sharply, and investigations are exposing weaknesses in billing oversight. The challenge for insurers and regulators is…
The Hospital Crisis Is No Longer Just Rural. For-Profit Hospitals Had More Than 3 Times the Closure Rate of Nonprofits.
A new JAMA study finds urban hospitals closing at rates comparable to rural ones. The sharper divide is between types…
The Claim Was Correct. The Patient Still Got the Bill.
When does a “paid claim” become a patient-balance problem? Usually weeks before anyone prints the statement. Picture a patient walking…