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Nov Industry Notes: UHC – New GA Modifier Requirements 

Beginning Feb. 1, 2025, UHC is adding the following GA modifier requirement for their commercial plans. If you know or...

Nov Industry Notes: Ohio – Four Managed Care Plans Selected for Next Generation MyCare Plans 

On November 1, the Ohio Department of Medicaid (ODM) announced four managed care organizations to serve as the Next Generation...

Payer Contracts: Looking Forward to 2025 

We blinked and it is November already. Holy Smokes! We are deep into the fourth quarter of 2024 and you...

How Does Data Reviewed Work When Coding E/M? 

Amount and/or Complexity of Data to Be Reviewed and Analyzed is one of three elements that determine the level for...

Sept Industry Notes: EOBs during the Change Healthcare Service Outage 

CDPHP: Issuing of EOBs during the Change Healthcare Service Outage  As a result of the Change Healthcare security issue and...

Sept Industry Notes: Sanford Health Plan

Sanford Health Plan: Change of Mailing Address  Sanford Health Plan has changed the mailing address for Medicare Advantage claims submitted...

Navigating Diagnosis Denials

RCM Operations Director: Brianna Crowley A growing concern in the healthcare system is the increased amount of diagnosis denials. Insurance...

ICD-10-CM: What’s New for 2025

How are we preparing for the end of year already? Didn’t 2024 just begin? Unfortunately, we are heading into fall...

Billing Out-of-Network, Flu Season, and Industry Updates

The Challenges of Billing Out-of-Network One of the biggest challenges for an urgent care is billing insurance as a non-participating...

Unleash Your Revenue Potential: Expert Strategies for Billing and Credentialing

Join Experity for an insightful webinar designed to tackle common billing and credentialing challenges.

Urgent Care Billing Best Practices for Optimal Revenue

Not recouping revenue owed is the number one most solvable urgent care billing issue most urgent cares have. This includes...

Change Healthcare (Optum) Outage FAQs

latest update: 4/4/2024 Experity/Waystar Webinar [UPDATED 4/4/24] Experity partnered with Waystar to host a second, one-hour webinar for SaaS clients...