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Health Insurance & Benefits
Plan types, HSAs/FSAs, open enrollment, and navigating coverage denials/appeals.
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Patients who fight health insurance denials often win
12+ hour, 32+ min ago (1240+ words) Few patients appeal when insurers decline to pay for their care. Many don’t even know they can. But new data show that when they do, they frequently win — in some plans, nine out of 10 times. Insurers disclosed this data on…...
TailorCare Approaches 1 Million Medicare Advantage Members Under Value-Based MSK Contracts
4+ day, 17+ hour ago (485+ words) The company’s value-based model delivers measurable improvements in both clinical and cost outcomes for MSK conditions, according to operational data from TailorCare’s 2024–2025 Impact Report and 2026... TailorCare Approaches 1 Million Medicare Advantage Members Under Value-Based MSK Contracts Nashville, Tennessee, Sept. 16, 2026 (GLOBE NEWSWIRE)…...
Switch Advantage Plans in October and the New Plan Cannot Require Reauthorization for Your Active Treatment for 90 Days. After That, Its Own Rules Can Take Over
3+ day, 19+ hour ago (626+ words) Switching Medicare Advantage plans mid-treatment triggers a federal rule most enrollees never hear about, and the date that protection quietly expires may matter more than any premium comparison you run this October. The Full Benefits Desk desk. Editor: Gerelyn Terzo....
As MA Denial Rates Rise, Hospitals Are Betting on Traditional Medicare Instead
4+ day, 2+ hour ago (786+ words) As Medicare Advantage denial rates climb, health systems are dropping plans and steering patients back to traditional Medicare. Pearl Health CEO Michael Kopko thinks the original Medicare Advantage bargain has broken down — and that the model may never have been…...
Medicare Approves 36 Cardiac Rehab Sessions After a Heart Attack. Each One Is a Separate 20% Bill, and at the Hospital It's More
4+ day, 2+ hour ago (568+ words) Medicare covers cardiac rehab after a heart attack, but the same 12 weeks of treatment at two different facilities can produce two very different total bills, and most patients choose a location before anyone explains the difference. The Full Benefits Desk…...
AI credentialing deal targets provider network gaps at scale
4+ day, 12+ hour ago (171+ words) Credentialing delays have long been a quiet drag on health plan network performance. A new deal signals the industry is starting to address the problem at a different scale. When credentialing stalls, employer-sponsored plans end up with thinner networks than…...
Hindsait Approved for the CMS Health Tech Ecosystem for Electronic Prior Authorization
5+ day, 4+ hour ago (256+ words) Sep 15, 2026, 10:02 ET HACKENSACK, N.J., Sept. 15, 2026 /PRNewswire/ -- Hindsait, Inc., a healthcare Intelligence company specializing in clinical natural language processing and prior authorization technology, today announced it has been approved for the Electronic Prior Authorization category within the CMS Health Tech Ecosystem. Hindsait…...
OIG urges crackdown on equipment suppliers in Medicare Advantage
5+ day, 4+ hour ago (462+ words) The agency says the CMS and MA organizations aren’t doing enough to screen durable medical equipment providers, especially out-of-network companies that aren’t enrolled in Medicare. Fraud related to DMEPOS – prosthetics, robotics, orthotics and supplies – “has been a long-standing issue in…...
New documents reveal problems with Medicare's prior-authorization pilot
5+ day, 5+ hour ago (131+ words) STAT is a media company focused on finding and telling compelling stories about health, medicine, and scientific discovery. We produce daily news, investigative articles, and narrative projects in addition to multimedia features, podcasts, and opinion pieces. We tell our stories…...
Advantage Plans Can Cap Your In-Network Bills at $9,250. A PPO's Combined Cap Can Reach $13,900, and Covered Out-of-Network Care Counts Toward the Bigger One
5+ day, 7+ hour ago (648+ words) She chose her Medicare Advantage PPO because it promised a clear out-of-pocket ceiling, and she planned her knee surgery around that number. What she did not know was that one out-of-network provider on her surgical team would activate an entirely…...