The Myth of LOS Revisited: Part 2
Stefani Daniels, MSN, ACM, CMAC
November 11, 2020
It’s time to move on from lost to cost per case. There is an argument to be made that length of stay (LOS) is no
It’s time to move on from lost to cost per case. There is an argument to be made that length of stay (LOS) is no
Reporting the use of PRFs will be an ongoing issue due to the fraud and abuse implications of misusing PRFs. The federal Provider Relief Fund
America’s new normal. Unemployed, uninsured, unbelievable! The U.S. Bureau of Labor Statistics indicates that 12.6 million Americans are on unemployment rosters around the country; 32.5
Time to bring back post-acute waivers The average American’s response to the COVID-19 public health emergency (PHE) in the spring of 2020 was swift and
OIG determines admissions to inpatient rehab not appropriate. Last week, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released
Sometimes, in an audit, it comes down to the definition of “medical necessity.” While the coronavirus pandemic is horrible already, it seems to be getting
Medline grants bridge the SDoH gap. Among the most effective funding initiatives for addressing the social determinants of health (SDoH) are those in which communities
LOS management is analogous to a sports team. Recently there has been a lot of posting, blogging, and articles on length of stay (LOS) and
Hospitals could be charged $250,000 or twice the demand amount, whichever is greater. In October 2020, the United States Department of the Treasury’s Office of
The first end-to-end, universally applied, culturally tailored, and fully integrated SDoH program in the country. COVID-19 has widened the gaps between the have’s and have-nots,
There are COVID-19 hot spots and now there are potential covid audit hot spots. The Coronavirus Aid, Relief, and Economic Security (CARES) Act was enacted
LOS versus MSPB—the same or different. Length of stay (LOS) and Medicare spending per beneficiary (MSPB): are they both necessary? Are they complementary, or different
Medicare regulations are complex and even seasoned professionals struggle to apply them consistently. Due to overwhelming demand, Dr. Hirsch returns for Part 2 of Ask Dr. Hirsch: Clarifying Medicare’s Most Misunderstood Rules to answer even more of Medicare’s most misunderstood questions, covering inpatient status, observation, SNF access, Medicare Advantage denials, and more. Join Dr. Hirsch as he provides clear, referenced answers to real-world questions submitted by your peers, helping you navigate Medicare compliance with confidence and clarity.
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
Stay ahead of FY 2027 reimbursement changes with expert analysis of MS-DRG shifts, NTAP updates, Medicare Code Edits, and emerging technologies impacting inpatient payment accuracy.
Stay ahead of FY 2027 ICD-10-PCS changes with expert analysis of new procedure codes, revised guidelines, and high-impact updates affecting reimbursement, compliance, and inpatient coding accuracy.
Master the FY 2027 ICD-10-CM changes, including new diagnosis codes, CC/MCC updates, and coding guideline revisions, with practical insights from nationally recognized coding and CDI experts.
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