The Claims, Coding and FWA Library

Our PCG Blog is intended to provide education to the Healthcare Market on AI claims software, claims review, claims adjudications, medicare fraud, medicare waste, lawsuits and settlements, medical coding, medical billing, and more! We provide statistics, links, downloadable content, and so much more every month!

Latest Articles

hospital closures,financial mismanagement,healthcare access
By Will Schmidt January 20, 2026
An in‑depth look at U.S. hospital closuresdue to poor financial and/or operational mismanagement; who, what, where, when, and lessons learned.
kaiser permanente FWA,kaiser FWA,kaiser settlements
By Will Schmidt January 16, 2026
Continued reporting and updating on Kaiser Permanente fraud, waste, abuse, settlemenet and corrective actions.
cpt 99490,chronic care management billing,ccm denial reasons
By Will Schmidt January 15, 2026
A complete CPT 99490 guide covering CCM eligibility, time requirements, documentation, modifiers, payment rules, and common denial scenarios under CMS and Medicare.
ai prior authorization, healthcare authorization automation, prior authorization compliance
By Will Schmidt January 12, 2026
A practical analysis of AI prior authorization—cost savings, automation benefits, compliance risks, and why payer-defined rules still matter most.
By Will Schmidt January 9, 2026
Full recap of the Annual HICE Conference for present and past; includes agendas, speakers, pricing, impact, and future considerations.
healthcare fraud Michigan,telemedicine fraud,Medicaid billing scams
By Will Schmidt December 31, 2025
Explore Michigan's latest fraud cases, including opioid mills, telemedicine kickbacks, pharmacy billing fraud, and more.
medical coding ai,chatgpt billing compliance,ivecoder software
By Will Schmidt December 23, 2025
Explore why ChatGPT falls short for compliant medical coding and how iVECoder, with AMA licensing and CMS updates, offers a safer, more accurate solution.
rcm audit,medical billing errors,payer compliance
By Will Schmidt December 23, 2025
Learn how to reduce denials, avoid compliance risks, and audit your billing company effectively. Includes 3 warning signs to watch for.
provider relations guide to reducing denials and improving compliance
By Will Schmidt December 23, 2025
Step-by-step strategy for provider relations teams to reduce denials, speed up payments, and use AI-enhanced Excel tools to support clean claims.
anthem data breach,phi violations,healthcare cybersecurity
By Will Schmidt December 16, 2025
Explore Anthem (Elevance) security breaches, HIPAA violations, and data privacy settlements from 2015–2025. Includes breach timelines, financial penalties, and compliance outcomes.

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