Clear Search
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3 Min Read

Court decides whether insurers can be sued for underpaid claims

A U.S. court of appeal ruled physicians who are assigned insurance policy benefits have the right to bring lawsuits against insurers who underpay for medically necessary services provided to covered patients.

Judicial Advocacy
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4 Min Read

10 principles to improve care for Medicare patients

More than 100 state and specialty medical associations joined the AMA in sending a letter to the government outlining principles that should govern improving care for Medicare patients.

Payment & Delivery Models
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3 Min Read

Standing together, physicians welcome and lead change: AMA CEO

“The American health care system evolves at a pace that would not have seemed possible not too long ago,” AMA Executive Vice President and CEO James L. Madara, MD, said in his address Saturday at the 2015 AMA Interim Meeting.

Leadership
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3 Min Read

5 trends that will impact how quality of care is measured

As ever-increasing amounts of data impact how practices are evaluated and paid, one expert points to trends that every physician should follow.

Payment & Delivery Models
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3 Min Read

5 Medicare payment policy updates you need to know for 2016

With the release of a nearly 1,360-page final rule, the Centers for Medicare & Medicaid Services (CMS) has issued the policies that will govern physicians’ Medicare payments in 2016. From the comprehensive list of updates, we’ve identified five particularly noteworthy changes you should know.

Medicare & Medicaid
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5 Min Read

5 contracting keys for success in an alternative payment model

Physician practices across the country are weighing a variety of payment models presented by commercial payers. If you’re trying to determine whether these models, which are meant to improve patient care while lowering overall costs, will work for your practice and patients in the long run, don’t miss these key factors.

Payment & Delivery Models
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3 Min Read

Supreme Court to weigh insurer payment transparency

Health insurers are fighting a state law that would create transparency for physicians and patients when it comes to health insurance payments. A case before the Supreme Court of the United States will determine whether a technicality will stand in the way of reform efforts and keep the insurance payment process cloaked in mystery.

Judicial Advocacy
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2 Min Read

How to handle ICD-10 issues

With the arrival of the Oct. 1 implementation deadline for ICD-10, you need to be sure your practice can take care of any claims processing issues that result from using the new code set. The AMA’s ICD-10 Web page allows you to report any issues your practice is experiencing with how Medicare is processing claims now that the ICD-10 code set is in effect.

Claims Processing
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3 Min Read

ICD-10 code mapping tools--can you trust them?

The Oct. 1 compliance deadline for ICD-10 implementation is just days away, and many physician practices may be relying on the aid of coding tools to help ease the transition from the ICD-9 code set. Experts caution that you should verify the accuracy of these tools and make sure the code best represents the patient’s diagnosis.

Claims Processing