Claims Processing

A new Medicare Trustees Report has projected that Medicare's Hospital Insurance Fund will run out of money in 2024, five years earlier than projected in last year's report.

A recent survey of employers shows more than half would like to improve their employees' health habits as a means of reining in the rising cost of providing health benefits.

Should brokers be compensated for helping consumers to enroll in government programs like the Pre-Existing Condition Insurance Plan (PCIP) created by the new healthcare reform law? Until now, the federal government’s answer has been “no.”

With six months to go before the HIPAA 5010 electronic claims submissions compliance date, the Centers for Medicare and Medicaid Services have announced two 5010 national testing days.

Anthem Blue Cross and APS Healthcare have announced an agreement that will see APS provide targeted care management and coordination of Anthem members enrolled in Medi-Cal's California's Seniors and People with Disabilities (SPD) Program.

A patient recruiter for a Houston-based durable medical equipment company is the latest to be convicted in court for a scheme in which Medicare was billed for wheelchairs supposedly damaged in a hurricane.

A leader of a prescription fraud scheme has been sentenced to six years in prison for healthcare fraud, HIPAA violations and aggravated identity theft.

An annual review of the nation's health insurers by athenahealth and Physicians Practices has placed Hartford, Conn.-based Aetna at the top of the list.

The Huron Consulting Group's healthcare practice is offering a new product that aims to help healthcare providers steer a straight path through the revenue cycle management maze.

California Attorney General Kamala D. Harris has announced a $241 million settlement - the largest recovery in the history of the state's False Claims Act - with Quest Diagnostics to recover illegal overcharges to the state's medical program for the poor.