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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...

Benefits of Adding Primary Care Services to Your Urgent Care 

In the last few years, the Centers for Medicare & Medicaid Services (CMS) has accelerated its long-term effort to strengthen...

How to Grow Your Urgent Care and Increase Patient Volume

Clinics need to find new streams of revenue to compensate for a fluctuating business environment. Here are three ways you...

Listening as Innovation: How Better Communication Is Shaping Urgent Care

In urgent care, speed has always been the measure of success. Visit volumes, throughput, and door-to-door times dominate the conversation...

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...

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...

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...

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,...

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...

How AI at the Front Desk Restores Human Connection 

Imagine a patient calling your urgent care clinic — and no one answers. Unfortunately, this isn’t rare. Nearly half of...

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...

More Coding Advice from Experity RCM Team: Multiple Codes Same Body Area

Something that we see frequently is multiple diagnosis codes related to the same body area being selected and billed on...