Since 2013, when the North Carolina legislature amended the Hospital Licensure Act to include Section 131E-91(c), there has been some debate as to what, if any, effect the language of subsection (c) …
Court Says VA Improperly Denied Emergency Care Reimbursement at Non-VA Facilities
In September 2016, a veteran (Wolfe) received emergency care at a non-VA facility. She incurred $22,348.25 in medical expenses. A claim was filed to her health insurer for reimbursement. The insurer …
UHC Medicare Advantage Change May Soon Lead to Increased Denials
In order to help maintain the financial feasibility of the Medicare program, Congress passed the Medicare Secondary Payer Act ("MSPA"). The rationale set forth was that Medicare should not …
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January 2020 Complex Claims Industry News
"The Veterans Affairs Department wasted over $223 million on transportation services and delayed payments for veterans’ medical bills, according to an agency investigation that stemmed from …
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The Top Three Challenges when Billing Hospital Workers’ Compensation Claims
Historically, resolving workers' compensation claims has required a very manual process. Providers have struggled to balance this laborious process and other demands. Challenge 1: Workers' …
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Argos Health Ranked #1 by Black Book for Complex Claims
Argos Health has been named the top complex claims provider for 2019 by Black Book. Black Book assessed client experience, loyalty and customer satisfaction in a survey of nearly 1,600 hospital and …
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