To protect their networks and bottom lines, health insurers don’t aggressively pursue widespread fraud, making it easy for scammers. Then...

Martand Bhatt's parents weren't sure he needed immediate medical care when the energetic toddler burned his hand on the kitchen stove one...

Code Creeping or Upcoding. It's all the same and the damage this has to employer plans across the country far exceeds the impact to...

Georgia's insurance commissioner has fined Blue Cross Blue Shield $5 million for violations of state laws and agency rules and...

We’re excited to announce that Stephen Carrabba, our President and co-founder, was featured in the most recent edition of The Self...

Don’t be surprised if the U.S. Department of Health and Human Services continues the COVID-19 public health emergency  in mid-July, based...

The Employee Retirement Income Security Act of 1974 (ERISA) is a federal law that sets minimum standards for most voluntarily established...

The Employee Retirement Income Security Act (ERISA)  protects your plan's assets by requiring that those persons or entities who exercise...

High-dollar claims are a persistent challenge for payers; a comprehensive payment integrity strategy can help payers ensure higher dollar...

Although telehealth offers many benefits for patients, it introduces operational complexities for providers and creates legitimate...

A Miami physician’s six-year, $38 million health care fraud scheme paid for luxury cars and beachfront condominiums, prosecutors say. But...

Starting in 2022, an estimated 2.5 million employer-sponsors of health plans are required to adopt new fee and pricing transparencies due...