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Becoming Their Clinic: Making Patient Experience Your Growth Engine

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Becoming Their Clinic: Making Patient Experience Your Growth Engine
Ladera Urgent Care, Integrative Urgent Care

Ladera Urgent Care, Integrative Urgent Care

casestudies Case Studies
How to Drive Patient Satisfaction With Shorter Urgent Care Visits

How to Drive Patient Satisfaction With Shorter Urgent Care Visits

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Should Nurse Practitioners Be Allowed to Read X-Rays? Pros, Cons, and the Path Forward

Should Nurse Practitioners Be Allowed to Read X-Rays? Pros, Cons, and the Path Forward

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Filter Resources

Update on Processing of Medicare Claims Impacted During the Government Shutdown 

Update on Processing of Medicare Claims Impacted During the Government Shutdown 

Multiple expiring Medicare statutory payment provisions lapsed on October 1, 2025, due to the absence of Congressional action. With the...
articles Blog
Medicare Part B Claim Issues Impacting JK and J6 Providers 

Medicare Part B Claim Issues Impacting JK and J6 Providers 

Denied Laboratory Services and Clinical Laboratory Improvement Amendments (CLIA)   NGS Medicare has been receiving calls from providers regarding denials for...
articles Blog
Nov Industry Notes: Open Claims Issue for Medicare Part B 

Nov Industry Notes: Open Claims Issue for Medicare Part B 

The claims issues log below includes the status of claims processing issues that have been identified. We are actively working...
articles Blog
Pennsylvania Department of Human Services Prior Authorization 

Pennsylvania Department of Human Services Prior Authorization 

PURPOSE:   The purpose of this bulletin is to issue updated handbook pages that include the requirements for prior authorization and...
articles Blog
Nov Industry Notes: Elevance to Penalize Facilities For Out-of-network Providers 

Nov Industry Notes: Elevance to Penalize Facilities For Out-of-network Providers 

Elevance Health (Anthem) will begin penalizing healthcare facilities in 11 states starting Jan. 1, 2026, for using out-of-network providers for...
articles Blog
What to Know About Cigna’s and Aetna’s New Downcoding Policies 

What to Know About Cigna’s and Aetna’s New Downcoding Policies 

Cigna and Aetna are drawing provider backlash for new payment policies that reduce reimbursements. Cigna is automatically "downcoding" six Evaluation...
articles Blog
Billing Integrity in Urgent Care: How to Manage Risk 

Billing Integrity in Urgent Care: How to Manage Risk 

The financial and reputational health of an urgent care practice depends on one simple principle: bill accurately and compliantly. Yet...
articles Blog
Medicare Administrative Contractors Status During the Shutdown 

Medicare Administrative Contractors Status During the Shutdown 

In anticipation of possible Congressional action, CMS has instructed all Medicare Administrative Contractors (MACs) to continue to temporarily hold claims...
articles Blog
Mail Forwarding to End for PO Boxes Formerly Located in Missouri 

Mail Forwarding to End for PO Boxes Formerly Located in Missouri 

To all providers:  On May 14, 2025, four PO boxes changed from the processing center in St. Louis, MO, to...
articles Blog
October Industry Notes – Medicare 

October Industry Notes – Medicare 

NCCI Alert: COVID-19 Vaccine Administration Edit Revision  Some providers may have 90480 claims denied when billed in conjunction with G0008,...
articles Blog
Update on Medicare Operations: Telehealth, Claims Processing, and Medicare Administrative Contractors Status During the Shutdown 

Update on Medicare Operations: Telehealth, Claims Processing, and Medicare Administrative Contractors Status During the Shutdown 

In the absence of a federal budget bill or continuing resolution, the government shut down on October 1, 2025, many...
articles Blog
September Industry Notes: Upcoming Code Change From the Medicare Bulletin:

September Industry Notes: Upcoming Code Change From the Medicare Bulletin:

For combination tests that are read visually, CPT code 87812 QW will be effective January 1, 2026. Until then, laboratories may bill CPT...
articles Blog
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