Telehealth billing remains complex as payer requirements continue to vary across procedure codes, modifiers, and places of service. Medicare, Medicaid, and commercial plans may apply different billing expectations, creating risk when providers use a uniform approach...
Hospice is designed to provide comfort and supportive care to terminally ill patients with a prognosis of six months or less. However, the high per diem payment structure makes it a significant target for sophisticated fraud schemes. Improper billing for hospice...
AI is transforming how healthcare payers protect their dollars. One of the best places to see this impact is in payment integrity. This is where health plans can use AI to prevent fraud, waste, abuse, and errors (FWAE) before claims are paid. It’s fast, effective, and...
