Anyone working in skilled nursing today understands how much is being asked of providers. Staffing challenges, reimbursement ...

DEAR DR. ROACH: When I have appointments with my physicians (at our local, highly rated academic health system), they no longer do a physical exam. But in the after-visit note, there is a documented ...

Andrew S. Oseran, MD, MBA, MSc, hypothesizes that higher Medicare Advantage (MA) risk scores may result from either a more accurate capture of beneficiaries' comorbidities or inappropriate "upcoding" ...

A Medicare Advantage plan run by CVS inflated diagnoses for its members between 2018 and 2019, resulting in almost $7 million in estimated overpayments, according to a new audit by the HHS Office of ...

Since last summer, health insurers have been telling investors that hospitals’ use of artificial intelligence tools for medical coding and billing is driving up the cost of health care. Insurers claim ...