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2 Min Read

Fair contracting

Stay informed using the AMA's resources to help regulate appropriate state laws related to managed care contracting.

Claims Processing
Exterior of court building.
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3 Min Read

New Jersey Supreme Court case could expose physicians to large fines

The Supreme Court of New Jersey is reviewing a case about insurance fraud and a physician’s referral of patients to health care facilities where they have financial relationships. At issue is if fraud is based on what the medical group or practice should have known, as opposed to what they actually knew.

Judicial Advocacy
Physician hand coming from computer screen for patient
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4 Min Read

Why one health insurer is embracing telemedicine

One health insurer discusses why telemedicine complements physical exams by a physician, rather than replacing office visits. Physicians must lead further development to make sure telemedicine works with medical practices.

Digital
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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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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

Ruling could give insurers more leeway to terminate physicians

The outcome of a recent case could have implications for other physicians and their patients as a federal court decided it was permissible for a large health insurer to terminate two physicians from its network following a dispute over the necessity of medical services they provided.

Judicial Advocacy
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2 Min Read

Court to weigh physicians' right to payments, recourse

Should physicians be left holding the bag when a private insurer retroactively denies a medical claim or recoups a payment? A federal appeals court is considering a case that could determine whether physicians have recourse to ensure that their practices remain financially stable so they can continue caring for their patients.

Judicial Advocacy
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3 Min Read

Common payment issues-and how to handle them

Physicians face many challenges in the day-to-day business of keeping a medical practice afloat, and one of the biggest is securing claims payments from health insurers. A new AMA resource helps physicians handle the process of identifying and appealing claims.

Claims Processing
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2 Min Read

3 things you must know about overpayment recovery

Learn what you need to know about the overpayment recovery process with these three tips and additional assistance from a free online overpayment recovery toolkit from the AMA.

Claims Processing