UHC Drops Lp(a) from Its Non-Coverage List
UnitedHealthcare has released an updated version of its Cardiovascular Disease Risk Tests medical policy for Commercial...
Leadership Insights
BCBS Nebraska Tightens MA Appeals and Cuts Radiology and Lab Reimbursement
BCBS Nebraska is updating the Medicare Advantage (MA) provider appeals process.
CMS, CDC, and HHS Seek Public Input on Potential CLIA Updates
Centers for Medicare & Medicaid Services (CMS), Centers for Disease Control and Prevention (CDC), and the Department of...
CMS Launches IDR Gateway: What Providers Need to Know Before September 15
In late 2026, the Federal Independent Dispute Resolution (IDR) process will transition from single-use web forms to the...
The Rise of CLIA-Related Rejections: What Labs Should Review
Since CMS transitioned CLIA certification to a paperless system in March, TELCOR has noticed an increase in...
Final Month of PAMA Reporting: Is Your Lab Ready?
July marks the final month of the 2026 PAMA reporting period. Laboratories that meet the definition of an applicable...
Humana Claims Payment Policies
Effective July 1, 2026, Humana will charge a $5.00 administrative fee for Medicare Advantage paper claim submissions.
Prior Authorization is Changing. TELCOR AI Systems is Built for What Comes Next.
Prior authorization has become one of the biggest operational challenges in healthcare reimbursement. Requirements...
Stay Compliant with CMS and the New ABN Requirements
The Centers for Medicare & Medicaid Services (CMS) has issued an updated version of the Advance Beneficiary Notice of...
Medicare MBI Changes: What Providers Need to Know to Prevent Claim Denials
TELCOR has noticed an increase in “missing/incomplete/invalid patient identifier” denials from Medicare.
Navigate Shifting Reimbursement Criteria for Molecular Testing
At TELCOR, we’ve recently identified a notable shift in how molecular claims specifically associated with CPT code...
Florida Law for Patient Refunds
Recent legislation in Florida now requires patient overpayments to be refunded within 30 days of identification,...