With the red tape of health insurance already causing frustration for millions of Americans, doctors are helping to shed light on a common industry practice: downcoding. This occurs when insurance ...
Guest host Karen Johnson, PhD, VP of Practice Advancement for the AAFP, talks with Tina Philip, DO, a solo family physician in Round Rock, Texas, and AAFP CEO/EVP Shawn Martin about payer downcoding, ...
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 ...
The ISMS-backed bill would prohibit health insurance companies from automatically coding a health service at a level lower than what patients received. This bill is another example of how Illinois ...
BCBSIL began applying an enhanced claims-review process July 1 to certain office, inpatient and outpatient E/M services, allowing the insurer to reimburse claims at a lower level when it determines ...
The day a Chicago woman named Rachel learned Blue Cross Blue Shield of Illinois was "downcoding" her longtime psychiatrist’s claims and cutting his pay, she immediately got to work.She reached out to ...
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