In the beginning of the year, Dr. Terry Wagner’s office manager came to him and said “something weird is going on.” For weeks, the office manager told him, Wagner had been quietly underpaid by the ...

SPRINGFIELD, Ill. (WAND) — A bill in Springfield could prohibit health insurance companies from using artificial intelligence to code a health service lower than what is actually provided to patients.

“Guilty until proven innocent.” That’s how one practice owner described downcoding policies being implemented by large insurers on local independent physicians. After reviewing billing statements, ...

Several federal agencies issued a set of final rules based on the No Surprises Act aimed at making it easier for providers to contest payer decisions. During the IDR process, an arbiter is directed to ...

SPRINGFIELD, Ill. (WAND) — The Illinois Senate Insurance Committee unanimously approved a bill to prohibit insurance companies from using artificial intelligence to code a health service lower than ...

U.S. physicians routinely are seeing their higher-cost claims downcoded by insurers, a strategy a family physician in Cincinnati called a revenue grab, according to Medscape. Will Sawyer, MD, said ...

Like many medical students, I had a difficult time choosing my specialty. I vacillated between a surgical, more procedure-oriented field and one focused on medicine. In 2003, and probably still today, ...

Insurers argue that providers use AI as well — to upcode claims to make more money. Recent research from Blue Health ...