Tag: Healthcare Transparency

Prior Authorization reforms

CMS Prior Authorization Reforms: A Step Forward, But More Needed

The updated CMS regulations on prior authorization have been lauded as a significant step toward reducing administrative burdens for physicians. However, critics argue that the changes fall short of addressing the broader issues. Accelerating Prior Authorization and Enhancing Transparency Issued in January, these regulations mandate federally regulated health plans to enhance electronic health information exchange […]
Medical Billing Upcoding

What are the Effects of Upcoding in Medical Billing?

Upcoding in Medical Billing, the act of billing for a higher level of service than was actually provided in medical billing, is unfortunately not uncommon. While it may seem like a harmless way to boost revenue, the consequences are far-reaching and detrimental to both patients and the healthcare system as a whole. Upcoding in Medical […]