Payers

Humana and Aetna's merger didn't work out - but the real story is how much Aetna was willing to pay to just back out of the agreement.

The 2016 Physicians Practice Fee Schedule Survey reveals how much more employed docs get paid than independent physicians for certain CPT codes.

This doctor is learning that genetics, nutrition analysis, microbiome surveys, and other personalized care services is what patients want.

Rep. Tom Price was confirmed by the Senate along party lines as the next Secretary of the Department of Health and Human Services.

A new infographic from RemitDATA reveals which five specialties and five procedures had the highest denial rate in 2016, as well as the five most common reasons why.

As the healthcare system in the U.S. undergoes a shift under MACRA, it's important to look at "access to care" and what it means.

It's almost Valentine's Day. Here are 10 "valentines" that you can send to your payers, to improve and develop this important "relationship."

While it's uncertain what will happen with the ACA this year and healthcare policy in general, it's clear something needs to be done, says one doc.

What do practices get paid for common codes? The results to the 2016 Fee Schedule Survey, featuring more than 1,100 respondents from across the country, provide the answers.

A New Year brings us the reality of some insurance plans not being compliant to new changes and never seen before denials.

A lot stands in the way of a strong patient-doctor relationship these days, specifically the cost of care. But physicians must remain committed.

A new poll from researchers at Johns Hopkins found that only 15 percent of primary-care physicians want a full repeal the Affordable Care Act.

How high-deductibles and copays are straining, but also strengthening, the trust between doctors and patients.

As Otto Von Bismarck once said, "If you like laws and sausages, you should never watch either one being made." That's true for new Safe Harbor regulations.

Do you trust insurance companies to pay you properly and according to contract requirements? If so, review your EOBs from your payers, today.

Potential HHS Secretary, Rep. Tom Price was targeted by Senate Democrats who questioned his ethics and his philosophy on health insurance for all.

In our recurring blog "Inbox," we also get reader feedback on payers not requesting overpayments and the biggest HIPAA incidents of 2016.

A new law makes it so small practices can reimburse employees for premium expenses incurred for an individual health insurance policy.

Value-based reimbursement and a few other trends that will have a major impact on physician practices in the coming year.

Sometimes CMS can unjustly revoke a provider's billing privileges. Here are a few examples.

Everyone should know about CMS' rule about repaying overpayments within 60 days. What about private payers?

Regardless of your political thoughts, no one knows what, when and how the ACA plans are going to play out. Make sure you're prepared.

Patients really want to be cared for. And it's important to realize that treating them is different than caring for them.

The term "value-based care" has been thrown around a lot. What does it mean to you and your practice?

What can practices learn from a recent ruling by the Supreme Court on the False Claims Act? An expert weighs in.

While employed physicians often cannot accept samples in their practice, this independent doctor can and does, to help his patients in need.

A pediatric roundtable at MGMA16 led to the realization that there's wisdom in identifying the industry forces that we cannot change.

CMS released a dashboard that revealed the amount of money spent by the agency on specific drugs. Maryland docs reject medical marijuana.

The 2017 Medicare Physician Fee Schedule (MPFS) Final Rule has been finalized and will take effect Jan. 1, 2017. Here's what you should know.

Is your practice ready for the new Medicare payment systems coming in January 2017? Now is the time to develop a plan.