Insurers argue that providers use AI as well — to upcode claims to make more money. Recent research from Blue Health ...

Health care providers in Oregon and across the country are worried about a new practice by commercial insurance companies of ...

As audits and downcoding become more common, audit defense isn’t a back-office function. It’s a financial imperative.” — Moghis Uddin, CEO of AlethianAI ...

The Medical Group Management Association (MGMA) today released its 2026 Regulatory Burden Report, highlighting how escalating federal regulatory and administrative requirements are overwhelming ...

Prior authorization, Medicare Advantage requirements and quality reporting are among the leading drivers of practices’ ...

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The health system claims the policy, which reduces reimbursement for some inpatient hospital stays, violates federal law and ...

MIAMI (AP) — Good Friday is a unique — and uniquely solemn — day in the Christian calendar. It commemorates the crucifixion and death of Jesus, ahead of what's a central tenet of faith for believers — ...

Maryland regulators fined Cigna Health and Life Insurance Company $80,000 and ordered it to stop reducing payments on certain doctor-billed services — a practice that could leave patients on the hook ...

The Muslim holy month of Ramadan is almost over, which means that Eid al-Fitr is coming soon. Millions of Muslims around the world every year observe Ramadan, a period of prayer, reflection and ...

An Illinois Senate bill introduced in February would ban payers from using automated tools, including AI, to downcode physician claims and would require that any downcoding decision be made by a ...