Aetna’s New Payment Policy: A Challenge to Hospitals and the Two-Midnight Rule
In November 2025, Aetna announced a major shift in its inpatient admission payment policy that could have significant financial consequences for hospitals. While the change appears to simplify approvals under the Two-Midnight Rule, it introduces hidden risks that may lead to reduced payments and eliminate hospitals’ rights to appeal.
Healthcare Policy Changes in 2025 and Beyond: What Providers Need to Know to Stay Ahead
The healthcare policy landscape in 2025 is transforming, affecting reimbursement models, telehealth expansion, and patient access rights. For providers, staying informed and proactive is not options - it's essential for financial stability and regulatory compliance.
New CMS Payment Rates for 2025–2026 Flu Season: What Providers Need to Know
On August 13, 2025, the Centers for Medicare & Medicaid Services (CMS) released the updated Medicare Part B payment allowance limits for the 2025–2026 influenza (flu) season. These rates are effective August 1, 2025, through July 31, 2026 and reflect important changes that providers need to account for in their billing processes.
2025 Telemedicine E/M Codes: A Complete Guide for Accurate Billing and Reimbursement
The American Medical Association (AMA) introduced 17 new CPT® codes for telemedicine E/M services in 2025. These codes reflect the growing demand for both audio-video and audio-only care, ensuring providers can accurately document and report virtual encounters.
Billing Excellence: 8 Proven Strategies to Maximize Revenue and Minimize Denials
Effective medical billing is no longer just an administrative task — it’s a core business strategy that determines the financial stability of your practice. According to MGMA, the average cost to rework a denied claim is $25–$118 per claim, and nearly 65% of denied claims are never resubmitted. This means that without a streamlined billing process, practices leave significant revenue uncollected.