Medicaid managed care policy shifts scheduled for 2026 are poised to affect how home care agencies process and submit claims significantly. New compliance benchmarks, reporting expectations, and data ...

Care Qventus launches gap and coding automation suite to improve patient care and increase reimbursement accuracy in real time.

The doctors’ association is blowing up the U.S.’ decades-old coding system for recording pregnancy services and starting fresh next year, bowing to calls from OB-GYNs and other maternity specialists.

On April 22, 2024, the U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) issued a Final Rule (CMS-2439-F), effective July 9, 2024, aimed at ...

Workforce shortages, regulatory complexities and economic challenges have put hospitals and health systems under immense pressure to improve operational efficiency, accelerate payments and reduce ...

Contract negotiations adhere to a rule that 80 percent of time should be used to prepare for the negotiation and 20 percent to negotiate. To help be more effective in achieving results when you ...

Explore how network integrity enhances managed care strategies, driving value-based care success and improving patient outcomes in health systems. According to a 2025 survey of 142 health care ...