The Texas AG is investigating Blue Cross Blue Shield of Texas over denials and prior authorization delays. What it means and what providers should do now.
RAC, UPIC, TPE, SMRC, CERT, Medicaid RAC and MFCU audits explained for behavioral health: who runs each, what triggers it, record deadlines, outcomes, appeals.
How IOP and PHP billing actually works: the HCPCS and revenue codes, hours requirements, ASAM levels, and the documentation that keeps intensive outpatient claims paid.
The behavioral health CPT codes that matter in 2026, what documentation each requires, add-on and telehealth rules, and the coding mistakes that cause denials.
The three elements payers require to prove medical necessity in behavioral health, with strong and weak examples, and the documentation gaps that trigger denials.
The 2024 Part 2 final rule is now enforceable. What a compliant SUD consent must include, what single consent changed, and the documentation that keeps you covered.
What ASAM level-of-care documentation payers actually expect, how to build a defensible justification across the six dimensions, and the gaps that get SUD claims denied.
The DOJ's new National Fraud Enforcement Division is using data analytics to flag outlier providers. Here is what behavioral health and SUD programs should know and do.
A behavioral health billing service typically takes 4 to 9 percent of everything it collects, which is why the in-house
About 51 percent of behavioral health denials are decided not in the billing office but in the chart, which is
Behavioral health denial rates run 15 to 22 percent, close to double the 9 to 12 percent for the rest
Only about 15 percent of health systems can prove a return on their revenue cycle AI, even as AI revenue
