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@zetterhealthcare.bsky.social
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Another BCBS program removing "incident to" billing and lowering reimbursement for APPs. Healthcare providers voice concerns about an upcoming Blue Cross policy change www.wmuk.org/wmuk-news/20...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting
Healthcare providers voice concerns about an upcoming Blue Cross policy change
Blue Cross Blue Shield of Michigan is making a change that will effectively cut reimbursements for certain providers this fall. BCBS says the move protects patients, but some in the healthcare…
www.wmuk.org
August 31, 2026 at 1:10 PM
Had a great time being interviewed by Leslie Kane! The Unknowns in Your Salary Plan Could Cost You www.medscape.com/viewarticle/...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business #healthcareconsulting #CHBC
The Unknowns in Your Salary Plan Could Cost You
Doctors often overlook or misunderstand important metrics and incentives in their compensation plan, which can drag down their income.
www.medscape.com
August 6, 2026 at 3:17 PM
Another insurer breaking laws to make more profit. Whistleblower lawsuit accuses Alignment of accounting fraud buff.ly/AgVkW6y
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business #healthcareconsulting #CHBC
Whistleblower lawsuit accuses Alignment of accounting fraud
A former executive is claiming that the MA insurer recorded millions of dollars as capital expenditures that should have been operating expenses, inflating its value. Alignment strongly denied the…
www.healthcaredive.com
July 9, 2026 at 4:44 PM
Hospitals are emerging from bankruptcy only to falter again. Until they change their business model, nothing changes. www.modernhealthcare.com/providers/mh... zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare #consulting #healthcare #physicians #compliance
Hospitals are emerging from bankruptcy only to falter again
Even though overall healthcare Chapter 11 filings fell in 2025, hospital bankruptcies rose, according to Gibbins Advisors.
www.modernhealthcare.com
April 14, 2026 at 9:41 PM
Aetna, Elevance, Humana Medicare marketing lawsuit moves forward. Commercial insurers are theives and scammers. www.modernhealthcare.com/insurance/mh...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business
Aetna, Elevance, Humana Medicare marketing lawsuit moves forward
The Medicare Advantage insurers face allegations they paid kickbacks to online brokerages for signing up healthy Medicare beneficiaries.
www.modernhealthcare.com
March 26, 2026 at 4:31 PM
David Zetter on Evaluating Insurance Companies and Plans – MARKETVISORY GROUP buff.ly/CQDnnqZhttps... #practicemanagement #medicalbilling #credentialing #zetterhealthcare #consulting #healthcare #physicians #compliance #business #healthcareconsulting #CHBC #practicestartups #revenuecyclemanagement
David Zetter on Evaluating Insurance Companies and Plans
If you take health insurance as payment, then choosing good payers makes sense. How do you figure out which payers to contract with? It’s a logical question that has a very involved, sometimes not so…
marketvisorygroup.com
December 16, 2025 at 5:28 PM
Implementing Proactive Revenue Cycle Policies and Procedures: Stop Chasing Money. buff.ly/HMPpByM
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #business #healthcareconsulting #CHBC #practicestartups #revenuecyclemanagement
December 16, 2025 at 4:45 PM
Finally!! Site-neutral policies, inpatient only list
ts for patients and Medicare.  tinyurl.com/4ntubunb
CMS finalizes 2.6% outpatient pay bump, site-neutral policies
Hospitals lambasted the final rule as inadequate, arguing the sector is facing significant financial pressures.
www.healthcaredive.com
November 24, 2025 at 5:56 PM
Republicans are racing to find a plan for enhanced ACA subsidies. Here’s what they are considering | CNN Politics www.cnn.com/2025/11/18/p...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business
Republicans are racing to find a plan for enhanced ACA subsidies. Here’s what they are considering | CNN Politics
With less than six weeks before a key set of Affordable Care Act premium subsidies expire, congressional Republicans are scrambling to come up with a plan to address the pain of health care premiums…
www.cnn.com
November 18, 2025 at 7:18 PM
UnitedHealth to stop covering most remote patient monitoring www.modernhealthcare.com/insurance/mh...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business #healthcareconsulting #CHBC #practicestartups
UnitedHealth to stop covering most remote patient monitoring
The health insurance giant will end coverage of remote patient monitoring services for most chronic conditions next year.
www.modernhealthcare.com
November 11, 2025 at 2:13 PM
Elevance to penalize facilities for out-of-network providers www.modernhealthcare.com/insurance/mh...
Elevance to penalize facilities for out-of-network providers
Elevance Health aims to cut down on out-of-network claims.
www.modernhealthcare.com
October 27, 2025 at 9:15 PM
PE DOES NOT BELONG IN HEALTHCARE! Emergency department deaths tick up following private equity acquisition: study www.healthcaredive.com/news/emergen...
Emergency department deaths tick up following private equity acquisition: study
Patients may be more likely to die in private equity-owned emergency departments than other similar facilities, according to a study published Tuesday in the Annals of Internal Medicine.
www.healthcaredive.com
September 24, 2025 at 5:31 PM
David Zetter on Holding Payors Accountable – MARKETVISORY GROUP marketvisorygroup.com/podcast/davi...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare #consulting #healthcare #physicians #compliance #business #healthcareconsulting #CHBC #practicestartups
David Zetter on Holding Payors Accountable
If you take health insurance as payment, payers are a big part of your practice. What happens when they mess up? How do you hold them accountable? Can you hold them accountable? My guest today says…
marketvisorygroup.com
September 16, 2025 at 6:37 PM
Medicare Advantage Risk Adjustment Failure!! www.beckerspayer.com/payer/medica... zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business #healthcareconsulting #CHBC #practicestartups #revenuecyclemanagement
Medicare Advantage risk adjustment 'a failing system': Report - Becker's Payer Issues | Payer News
A group representing nonprofit health plans is raising concerns over what it claims is a wide variation in Medicare Advantage risk adjustment scores across insurers, leading to what it calls a…
buff.ly
September 4, 2025 at 4:18 PM
More thieves are stealing from the Medicare Trust Fund. This has to stop! www.healthcaredive.com/news/unitedh... zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business #healthcareconsulting #CHBC #practicestartups
UnitedHealthcare, Humana are gaming Medicare Advantage risk adjustment, analysis finds
The research from the Alliance for Community Health Plans adds to existing evidence that major insurers are unfairly profiting from MA’s risk adjustment system, driving billions of dollars in…
buff.ly
September 4, 2025 at 3:00 PM
Interviewed by the great Leslie Kane! When to Sell Your Medical Practice to a Private Equity Firm or Hospital www.medcentral.com/biz-policy/p...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business
June 9, 2025 at 8:43 PM
Do payors do anything legally? Centene joins other insurers facing 'ghost-network' allegations www.modernhealthcare.com/insurance/ce...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business #healthcareconsulting
Centene joins other insurers facing 'ghost-network' allegations
"Ghost-network" lawsuits allege insurance companies list providers in their directories who are deceased, retired or otherwise unavailable.
www.modernhealthcare.com
June 4, 2025 at 2:34 PM
The illegal activities by payors are never-ending. Judge rejects bid to dismiss MultiPlan antitrust complaints www.modernhealthcare.com/legal/clarit...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business
Judge rejects bid to dismiss MultiPlan antitrust complaints
The data analytics firm, now operating as Claritev, sought dismissal of the claims in two ongoing lawsuits.
www.modernhealthcare.com
June 4, 2025 at 2:20 PM
Thank you to Leslie Kane for the interview! When to Sell Your Medical Practice to a Private Equity Firm or Hospital www.medcentral.com/biz-policy/p...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business
June 2, 2025 at 2:28 PM
Isn't it time for UHC to held accountable? UnitedHealth Group faces lawsuit claiming it used ex-employees' 401(k) funds to defray its own costs fortune.com/article/unit...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare #consulting #healthcare #physicians #compliance
UnitedHealth Group faces lawsuit claiming it used ex-employees' 401(k) funds to defray its own costs
It’s the latest in a surge of lawsuits for the beleaguered health care giant, and the company has denied the allegations.
fortune.com
May 29, 2025 at 3:19 PM
What a joke of an insurer. UnitedHealth Group Incorporated (UNH) Faces Mounting Backlash Amid Billing Disputes, CEO Resignation, and Criminal Probe finance.yahoo.com/news/unitedh...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians
UnitedHealth Group Incorporated (UNH) Faces Mounting Backlash Amid Billing Disputes, CEO Resignation, and Criminal Probe
UnitedHealth Group Incorporated (NYSE:UNH)’s UnitedHealthcare, the largest private health insurer in the U.S., is facing unprecedented public and regulatory scrutiny amid mounting patient frustration…
finance.yahoo.com
May 28, 2025 at 5:15 PM
Could be worst ins co in US. Insurance Company Accused of Pressuring Medical Staff to Change Patients' Status to "Do Not Resuscitate" futurism.com/neoscope/uni...
zetter.com #practicemanagement #medicalbilling #credentialing#zetterhealthcare #consulting #healthcare #physicians #compliance #business
Insurance Company Accused of Pressuring Medical Staff to Change Patients' Status to "Do Not Resuscitate"
Practitioners say that UnitedHealth pressed them to change patients' status to "do not resuscitate," The Guardian reports.
futurism.com
May 22, 2025 at 12:51 PM
More shenanigans. Insurers are thieves. UnitedHealth under criminal probe for possible Medicare fraud, WSJ reports finance.yahoo.com/news/unitedh...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business
UnitedHealth under criminal probe for possible Medicare fraud, WSJ reports
UnitedHealth said it had not been notified by the DOJ about the "supposed criminal investigation reported," and the company stood by "the integrity of our Medicare Advantage program." The health…
finance.yahoo.com
May 19, 2025 at 7:51 PM
Site-neutral Medicare pay eyed to fund Trump tax cuts. About time to remove this payment to hospitals. www.modernhealthcare.com/politics-pol...
zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business
Site-neutral Medicare pay eyed to fund Trump tax cuts
Republicans eager to offset the cost of cutting taxes may see lower Medicare spending on outpatient care as a source of budgetary savings.
www.modernhealthcare.com
March 21, 2025 at 4:58 PM
I will believe it when I see it. Cigna to spend $150M to improve prior auth, patient advocacy: CEO https://buff.ly/4aEbORnhttps://zetter.com #practicemanagement #medicalbilling #credentialing #zetterhealthcare
#consulting #healthcare #physicians #compliance #business #healthcareconsulting #CHBC
Cigna to spend $150M to improve prior auth, patient advocacy: CEO
Cigna Group CEO David Cordani said the company will make investments this year to improve patient and provider experiences with the insurer.
buff.ly
January 30, 2025 at 10:36 PM