Denials & Appeals

I was wondering if anyone had experience with denials from commercial payers that goes beyond the third level of appeals. We are getting response...Read More »

A Humana health plan in Florida overcharged Medicare by nearly $200 million in 2015 by incorrectly billing for high severity...Read More »

Sunrise Hospital & Medical Center in Winchester, Nevada, submitted Medicare claims for rehabilitative services that did not comply with...Read More »

by Brian Murphy

The Office of the Inspector General (OIG) dropped their latest bombshell. It concerns the...Read More »

Findings from an Office of Inspector General (OIG) audit show that Blue Cross...Read More »

A report from the Office of Inspector General (OIG) shows that Medicare billing...Read More »

Between mid-2017 and pre-pandemic 2019, 774 hospitals have been penalized by the federal government for having high rates of patients with...Read More »

According to an Office of Inspector General (OIG) audit, CMS did not use...Read More »

The Office of Inspector General (OIG) released an audit report for Providence...Read More »