Providers' offers were selected in 85% of payment determinations in 2024, according to the CMS federal IDR supplemental background report for 2024. That figure doesn't mean filing more cases is the strategy. It means the No Surprises
Providers' offers were selected in 85% of payment determinations in 2024, according to the CMS federal IDR supplemental background report for 2024. That figure doesn't mean filing more cases is the strategy. It means the No Surprises
Anesthesia billing can't be treated as routine claims processing. By the end of 2025, approximately 5 million federal Independent Dispute Resolution claims had been filed, nearly 14 times the volume regulators initially expected, according to the USC
The 2024 CAQH Index identified a $20 billion annual savings opportunity if U.S. healthcare organizations shift more administrative transactions from manual or partially electronic workflows to full automation, equivalent to roughly 22% of the costs measured in
Your multispecialty group switches billing vendors because denials keep climbing and paid claims keep coming back short. Six months later, clean claim volume looks better on the dashboard, but your CFO still can't explain where the underpayments
CPT 52204 is the base code for cystourethroscopy with bladder and/or urethral biopsy, reported as one unit per session regardless of how many specimens are taken. Additional specimen containers don't create additional billable units. The harder question
At least 32% of outpatient commercial claims and 11% of traditional Medicare claims remained unpaid after 90 days, the American Medical Association reported. The same source found that average initial denial rates rose from 9% in 2016
Healthcare organizations spent approximately $89 billion on the administrative transactions tracked by the CAQH 2023 Index, about 22% of the broader administrative spending measured in the report, with an estimated $18.3 billion savings opportunity from fully electronic
In 2024, 53 million prior authorization determinations were made for Medicare Advantage enrollees, according to KFF. That scale changes how you should judge prior authorization services. They're not a clerical shortcut for moving forms. They're a cash
Nearly 1.2 million new disputes were submitted in the first half of 2025, more than double the nearly 590,000 disputes filed in the first two quarters of 2024, according to the CMS Independent Dispute Resolution reports. That's
In a 2024 survey of 1,000 practicing physicians, the American Medical Association survey found physicians completed an average of 43 prior-authorization requests per week and spent about 12 hours weekly on those requirements with their staff. That's
