In the News

Nothing like boldly defining your priorities! CMS announced on April 7, 2025 that Medicare Advantage payers would receive a 5.06% increase for 2026 – about $25 billion more than in 2025. Stock prices jumped. It was a Medicare Advantage payday

It was reported last week that the PECOS upgrade which was supposed to have been released in 2023, has been consigned to the scrap heap by DOGE. It was Medicare Provider Enrollment’s version of the next George RR Martin Game

TriWest Healthcare Alliance, the new contractor for Tricare’s West Region, took over operation of the military’s health plan on January 1, 2025. It’s been nothing but a complete SNAFU…! The previous contractor, HealthNet Federal Services, will only have their customer service lines staffed

Here we go again! I’ve been informed that clinicians in Anthem BCBS states are receiving the “you’re billing too many 90837 sessions compared to your peers” letters.  It’s become routine: occasionally Anthem will send letters which warns you’re billing 90837 more than the

Multiplan announced a name change on February 18th. The new name is Claritev. But watch out: nothing they do will change! New name, same game: they’ll still try to reduce your reimbursement if you’re out of network – which is why superbills rather than  “courtesy billing”