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Our latest healthcare insights and perspectives

PAYMENT INTEGRITY

eBook: Setting up for coordination of benefits (COB) success

Evan Okulanis

Nov 12, 2025

Latest Content

PAYMENT INTEGRITY

The practical landscape of AI in payment integrity and VBP

Brett Arnold

Nov 5, 2025

FRAUD, WASTE, AND ABUSE

FWA Insights: Stopping “phantom providers” with prepay intervention

Erin Rutzler

Nov 3, 2025

QUALITY AND STARS

2026 Star Ratings: What they mean and what comes next

Marge Ciancetta

Oct 29, 2025

PAYMENT INTEGRITY

Case Study: Regional Blue Plan performs beyond hype with Data Mining

Kevin Laskey

Oct 23, 2025

Popular

01

Busted: The top fraud schemes of Q2 2025

Erin Rutzler

Sep 25, 2025

02

Busted: The top healthcare fraud schemes of Q4 2024

Erin Rutzler

Mar 19, 2025

03

FWA Insights: Solving durable medical equipment (DME) challenges

Yolanda Wilson, MPH, CPC

May 13, 2025

04

Busted: The top fraud schemes of Q1 2025

Erin Rutzler

Apr 30, 2025

RISK ADJUSTMENT

10 tips for a successful commercial risk adjustment program

Katie Sender, MSN, RN, PHN, CRC

Jul 23, 2024

RISK ADJUSTMENT

Video: Navigating new frontiers in risk adjustment

Katie Sender, MSN, RN, PHN, CRC

Jul 9, 2024

RISK ADJUSTMENT

3 key risk adjustment strategies to drive success in 2024

Katie Sender, MSN, RN, PHN, CRC

Apr 18, 2024

RISK ADJUSTMENT

New approaches to enhance risk adjustment at RISE National 2024

Katie Sender, MSN, RN, PHN, CRC

Mar 5, 2024

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