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Capitated Insurance Contracts: High Risk. Low Returns.

Medicare Overpayments

Retroactive Adverse Benefit Determinations

Capitated Insurance Contracts: High Risk. Low Returns.

Some medical providers receive payment for their services via capitated insurance contracts. Capitation is a risk-based payment system. Under a capitated insurance plan, the medical…

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Medicare Overpayments

Medical providers who participate with Medicare should be aware of the federal False Claims Act (FCA) and the potential consequences for failing to follow its…

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Retroactive Adverse Benefit Determinations

One of the most frustrating experiences for a medical practice’s billing staff is an insurer’s denial of previously authorized benefits. This is especially problematic when…

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