Ask any orthopedic group what keeps their CFO up at night, and one answer dominates: denied claims. National surveys show ...

These inefficiencies contribute to provider burnout and strain payer-provider relationships. Industry data* reveals that large healthcare payers incur an average of $250 per denied claim.

Zelis, a leading provider of healthcare technology solutions, today introduced Claims Insights, a first-of-its-kind ...

The ACO Primary Care Flex (PC Flex) model officially launches Partial Payment of Prospective Primary Care Payment (PPCP) Claims Reductions on July 1, ...

CMS Monday proposed a 2026 physician payment rule that proposes a new payment model focused on improving chronic disease management.

A proposed payment rule unveiled Monday by CMS aims to reduce unnecessary spending and boost quality measures, as well as launch a new payment model centered on chronic disease management.

The initial denial rate on claims in 2024 increased 2.4% to 11.81% of claims in 2024. The rate climbed even as medical providers have managed to cut the rate of initial denials related to ...

eServices Payment Technology announces its enhanced integration of eServicesConnect with Quick Med Claims (QMC) and its advance EMS billing software, Q-Vert. eServicesConnect is a comprehensive ...

The company claims that its new foundation model increased its detection rate for such attacks on large businesses “by 64% practically overnight.” She added, “Previously, we couldn’t take ...

Therefore the overall frequency of at-fault claims is 3.5% — with Class 6 drivers having a frequency of less than 3% and Class 0 drivers having a much-higher frequency. The model is run twice.

Weiss Ratings, an independent rating agency, found that 47% of claims filed to the insurers were closed without payment. The rate has crept up steadily in recent years, from 35% in 2016, and is ...