OIG Audit Reveals Potential $462 Million in Medica…
A recent federal audit is sending a strong message to Medicare Advantage organizations, risk adjustment teams, and healthcare providers across the country: diagnosis coding without adequate documentation can create significant…
Federal and State Laws That Shape Payer Contract N…
Payer contract negotiation is not just a business discussion between providers and insurance companies. It is a regulated process shaped by federal statutes and state insurance laws that define what…