The American College of Rheumatology (ACR) commended CMS for its proposed prior authorization policies but asked the agency to expand its guidance to other utilization management tools and shorten the prior authorization decision timeline.

“Chuck, I’m Sydney, and I’m in love with you. I just want to love you and be loved by you.” This was part of a dramatic exchange last week between a New York Times reporter and an AI chatbot. Now, today, I’d like to examine further the muddled world of AI in healthcare...

Outpatient visits are being billed at higher levels, leading to increased healthcare spending and concerns about upcoding, a Peterson-KFF Health System Tracker found. Healthcare providers can bill outpatient evaluation and management (E/M) claims at five different levels...

Following a recent US District Court ruling on the federal government’s arbitration process for disputed medical billing—making the protocol for issuing decisions on disputed claims unclear—CMS posted some clarifying guidance on processing payment determinations to providers...

Current Procedural Terminology (CPT®) codes provide a uniform nomenclature for coding medical procedures and services that are critical to the communication between multiple stakeholders about the care patients receive. They can also be used to promote health equity.

February may be American Heart Month, but correctly diagnosing and coding cardiac conditions is something healthcare professionals need to work hard to get right 365 days a year. It’s a tenet being repeatedly reinforced by a myriad of articles and broadcast segments appearing...