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The Centers for Medicare & Medicaid Services (CMS) recently released its CY 2026 Advance Notice for Medicare Advantage (MA) capitation...

In the complex ecosystem of healthcare billing and reimbursement, three technical yet mission-critical processes govern how services are...

In 2025, the evolution from basic claims editing to holistic payment integrity is no longer a trend—it’s the new standard in healthcare...

Every hospital and health system knows that Diagnosis-Related Groups (DRGs) are foundational to Medicare reimbursement. But what often...

On April 7, 2025, the Centers for Medicare & Medicaid Services (CMS) released its official 2026 Medicare Advantage (MA) Capitation Rates...

In the complex world of U.S. healthcare reimbursement, accuracy is everything. Providers rely on timely, correct pricing data to ensure...

Complete Guide to Inpatient Rehabilitation Facility PPS Reimbursement Methodology: The Inpatient Rehabilitation Facility Prospective...

Healthcare providers, billing teams, and payer partners must continuously adapt to new Medicare regulations that affect reimbursement...

In today’s rapidly evolving healthcare landscape, providers and payers alike are seeking cost-effective, patient-centered care solutions...

The Centers for Medicare & Medicaid Services (CMS)  has updated its Inpatient Prospective Payment System (IPPS) Pricer  to exclude...

In an era of shrinking margins and increasing regulatory scrutiny, healthcare organizations can't afford to overlook one silent killer of...

Introduction The Centers for Medicare & Medicaid Services (CMS) continuously updates its payment systems to align more closely with the...

Understanding Prospective Payment Systems in Healthcare The healthcare industry is complex and ever-evolving, with various payment models...

The   Centers for Medicare & Medicaid Services (CMS)  has released a preview for the upcoming Fiscal Year 2026 Inpatient Prospective...