Medical Billing

CO Supreme Court: Hospital Cannot Enforce $229K Surprise Bill

by Victoria Bailey

The Colorado Supreme Court has ruled that a woman is not liable for her $229,000 surprise bill from a Centura Health hospital, as the hospital did not disclose the amount to her before the...

Fewer Adults Faced Medical Debt Challenges During Pandemic

by Victoria Bailey

The pandemic may have brought some financial relief to consumers, as the share of adults experiencing medical debt challenges decreased in 2021, an Urban Institute report found. Researchers used data...

Home Healthcare Company Settles False Claims Act Violations

by Victoria Bailey

Signature HomeNow, a home healthcare company operating in Florida, has reached a $2.1 million settlement to resolve allegations that it violated the False Claims Act and fraudulently billed Medicare...

CA Doctor Sentenced in Medicare Fraud Scheme Involving Upcoding

by Victoria Bailey

A California doctor has been sentenced to prison for nearly eight years after his involvement in a $12 million Medicare fraud scheme in which he upcoded and billed Medicare for unnecessary...

Colorado Bill Aims to Limit Debt Collections, Boost Price Transparency

by Victoria Bailey

The Colorado House has passed a bill that seeks to prohibit hospitals from pursuing debt collections against patients if the health system does not comply with the CMS hospital price transparency...

Medical Debt Challenges Common Among Consumer Complaints

by Victoria Bailey

Americans continued to face medical debt challenges, with consumers reporting instances of debt collectors attempting to collect medical debt that was already paid or does not belong to them, according...

Florida Practice Pays $24.5M to Resolve False Claims Act Violations

by Victoria Bailey

Florida-based Physicians Partners of America (PPOA) has reached a $24.5 million settlement to resolve healthcare fraud allegations that it violated the False Claims Act and billed federal healthcare...

Providence Reaches $22.7M Settlement to Resolve Healthcare Fraud

by Victoria Bailey

Providence Health & Services Washington (Providence) has reached a $22.7 million settlement to resolve healthcare fraud allegations that it falsely billed Medicare and Medicaid for medically...

Biden Admin Announces Plans to Alleviate Medical Debt Burden

by Victoria Bailey

The Biden-Harris administration has announced a series of reforms that aim to alleviate medical debt burden and increase consumer protections for Americans. One in three adults across the country has...

Consumers Faced Surprise Medical Bills, Payment Struggles in 2021

by Victoria Bailey

The majority of consumers faced surprise medical bills in 2021 and expressed concern about financial hardships due to outstanding healthcare costs, InstaMed’s 12th annual Trends in Healthcare...

70% of Medical Collection Debt Will Leave Consumer Credit Reports

by Victoria Bailey

Three nationwide credit reporting agencies have announced that they will remove nearly 70 percent of medical collection debt tradelines from consumer credit reports to help ease the burden that...

New Revenue Cycle Management Offerings Introduced at HIMSS22

by Victoria Bailey

A handful of software companies introduced new products this week at the annual Healthcare Information and Management Systems Society (HIMSS) Global Health Conference and Exhibition in Orlando,...

Revenue Cycle Management Leaders Need Registrars, Billing Specialists

by Victoria Bailey

Frontline healthcare workers are not the only ones facing staffing shortages. Registrars, billing specialists, and patient follow-up staff were the most in-demand revenue cycle management positions for...

WEDI Voices Concerns About Good Faith Estimates Implementation

by Victoria Bailey

The Workgroup for Electronic Data Interchange (WEDI) expressed concerns to CMS regarding the good faith estimates policy under the No surprises Act and the problems it causes for providers and patients...

AHA: Good Faith Estimates Create Administrative Burden for Hospitals

by Victoria Bailey

The American Hospital Association (AHA) has asked CMS to adjust the good faith estimates policy under the No Surprises Act, citing the accompanying administrative burden and operational inefficiencies...

Credit Reports Showed $88B in Past-Due Medical Debts in 2021

by Victoria Bailey

Consumer credit reports disclosed around $88 billion in past-due medical debt in 2021, underscoring the burden of healthcare costs and the barriers individuals face in the wake of high medical...

Lower-Income, Younger Americans Faced More Medical Debt Struggles

by Victoria Bailey

Healthcare finance struggles plague adults in every generation, with a quarter of Generation Z and Millennial Americans reporting that they skipped their rent or mortgage payments due to medical debt,...

Exploring the Fundamentals of Medical Billing and Coding

by Editorial Staff

Medical billing and coding translate a patient encounter into the languages healthcare facilities use for claims submission and reimbursement. Billing and coding are separate processes, but both are necessary for providers to receive...