Anthem Blue Cross of California is extending the pause on its upcoming evaluation and management claim downcoding policy until April, the insurer confirmed to Becker’s Feb. 27. A Feb. 23 news release ...

Blue Cross Blue Shield of Massachusetts is expanding its claims review process to address what it is describing as potential overcoding among physicians who routinely bill for high-complexity visits.

Prefer Newsweek on Google to see more of our trusted coverage when you search. Artiticifial intelligence technology company Suki announced an expansion for its assisted revenue cycle capabilities ...

Physician advocacy groups are urging Cigna to withdraw a new reimbursement policy that would automatically downcode high-level E/M claims, arguing it undermines clinical judgment and creates an unfair ...

The California and Texas medical associations are urging Cigna to rescind a new policy they say will increase administrative burdens and create a barrier to appropriate reimbursement. Beginning Oct. 1 ...

In the U.S. healthcare industry, claim denials are a significant issue, costing healthcare providers billions of dollars every year. it’s estimated that denied claims amount to astounding $250 billion ...

Aetna recently announced that effective September 1, 2025, its Claim and Code Review Program (CCRP) will expand to include additional claim coding edits for all commercial, Medicare, and Student ...

The overwhelming majority of health care compliance professionals surveyed for a new study agreed with this statement: “If a clinician’s action is not documented it is not ‘done.’” That sets up an ...