Blue Cross Blue Shield Michigan has clarified their policy surrounding a modifier applied to certain outpatient surgical codes. In February, BCBS Michigan released a new reimbursement policy ...

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.

Suki, an ambient AI healthcare company, is expanding its assisted revenue cycle capabilities to provide more specific automation and generate additional codes, including CPT and E/M codes. Suki, which ...

THE EUROPEAN Respiratory Society (ERS) and European Alliance of Associations for Rheumatology (EULAR) have released new clinical practice guidelines to support the diagnosis, monitoring, and treatment ...

A startup called Empromptu Inc. is looking to deliver where all other artificial intelligence-based application building tools have failed. It’s launching what it says is the first platform of its ...

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 ...

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 ...