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…
Category: Policy Updates
ICD-10-CM FY2027 Is Live: 9 Code Changes to Check Before Your Next Claim Batch
By Elizaveta Bannova, Billing Department, WCH It took effect a week ago. If an outdated code is still sitting in…
Under 90 Days: Telehealth Prescribing Rules Are About to Change — But the Final Rule Is Still Under Review
By Elena Pak, Credentialing Department, WCH A pandemic-era flexibility expires December 31. A permanent replacement is under federal review, but…
Your AI Vendor May Be Your Compliance Risk: What Physicians Should Ask Before Putting AI Into the Practice
By Slava Kurdov, Billing Department, WCH
Payers Are Changing Your Rates. Most Practices Haven’t Noticed Yet.
By Tatyana Kantor, Billing Department, WCH Rate changes are showing up across New York Medicaid MCO plans, contracts, specialties, and…
Your Payer Contract May Be Paying You Less Than You Think
A contract is signed once. It is rarely read again. Most practices treat a payer contract as a fixed reference…
Aetna Is Changing Cancer Prior Authorization. Here’s What Oncology Practices Need to Know
If you run an oncology practice that sees Aetna patients, you already know the drill: diagnosis, then paperwork, then more…
The Medicare Advantage DMEPOS Gap Every Prescribing Physician Should Know About
By Elena Pak, Credentialing Department, WCH Quick question: when you write a durable medical equipment order for a Medicare Advantage…
The Prior Authorization Deadline Is Now a Revenue Tool — If You Track It
For as long as most physicians have been in practice, prior authorization timelines have varied wildly depending on the payer,…