The term “medical necessity” is used far and wide in medical care. But medical necessity is not a singular concept, like gravity, nor is it completely undefinable, like love. As a broad definition, it means that the plan of care is going to benefit...

Many nursing home COVID-19 patients would have benefited from daily, reimbursed-for physician visits in their skilled nursing facilities, but they were not entitled to them. 

The Centers for Medicare & Medicaid Services (CMS) has issued its first proposed payment rules under the Biden Administration. While these rules are required to update Medicare payment rates for different provider types, they...

With dwindling provider availability and a growing patient population, the healthcare industry is increasingly turning to technological advancements to improve patient outcomes. During the pandemic, the industry was forced to adapt, leading many practitioners...

By April of last year, seemingly every news station in American was featuring the heroic efforts of physicians, nurses, and other clinicians fighting COVID-19. These providers transformed healthcare, implementing telehealth and virtual care.

For years, providers have been plagued with defending claims for medically necessary services that have been denied due to insufficient documentation and technical reasons. This leads to the Medicare program and commercial...