Providers governed by CMS Medicare administrative contractor (MAC) National Government Services can expect a series of claims adjustments for falsely rejected claims in the coming weeks.

Members of both houses of Congress released details of a new plan to do away with the sustainable growth rate (SGR) and the annual “doc fix” that goes with it. Physicians will probably not be pleased.

While primary care providers showed a big increase in level 3 E/M utilization in 2012, level 3 utilization stayed flat for specialists. However...

Providers can now have a member of the practice or a third-party enter or modify enrollment information about them in PECOS. Here's how.

You are likely to leave money on the table in the form of lower rates for patients with ACA exchange plans when you don’t proactively act on contract amendments sent by your existing health payers, experts says.

Before your practice reduces staff to save money, take a detailed look around — ideas for trimming unnecessary costs may be hiding in plain sight.

Private payers have noticed the extra scrutiny your Medicare fee-for-service claims face from different auditors, and they’ve been getting in the act as well – launching aggressive audits, claims reviews and denials management strategies hitting your bottom line.

If you plan to appeal denied claims, it helps to know (using CMS data) what your chances are. 

The former acting head of the Centers for Medicare & Medicaid Services lauds efforts such as the Choosing Wisely campaign, which aim to reduce medical interventions "for which the risks outweigh the benefits."