Blue Cross Blue Shield (BCBS) is set to enhance its paid claims editing process for Medicare Advantage and Medicaid members starting in 2026. This update aims to improve accuracy and efficiency in claims processing, which will affect healthcare providers and payers alike. Understanding these changes is crucial for healthcare professionals who manage billing and reimbursement for these populations. What Paid Claims Editing Means for Medicare Advantage and Medicaid Paid claims

Providers might be fielding inquiries about Medicare telehealth coverage due to the government shutdown that started on October 1, 2025. Please refer to the information below for consistent communication with members. Per Superior's newsletter there is no disruption to telehealth coverage for our Medicare members or providers. Although federal flexibilities for traditional Medicare ended on September 30, 2025, our Wellcare, Wellcare By Allwell, and Wellcare By Superior Healt

The healthcare industry is often criticized for its complex processes, particularly prior authorization requirements. Many patients experience frustrating delays in receiving necessary care due to these bureaucratic hurdles. Recognizing this urgent need for change, Humana—a leading health insurance provider in the United States—has taken significant action to eliminate prior authorization requirements for specific services. This blog post looks at Humana's innovative initiati

Apex Practice Solutions has received an A+ rating from the BBB for another year. We could not have achieved this top rating without our...

Billing for self-pay is pretty straightforward, however, there are some considerations to keep in mind. 1. Medicare law prohibits...