Providers and federal officials alike continue to adjust to the new normal, and an uncertain future. EDITOR’S NOTE: Dr. Ronald Hirsch, vice president of R1
COVID-19 has populations at risk for all determinants, especially the “housing compromised.” Homelessness was 2019’s top social determinant of health (SDoH). 2019’s Annual Point in
Optimal post-acute recovery depends on engagement with patients. Now more than ever, in the face of COVID -19, the Conditions of Participation for Medicare (CoP)
The Coronavirus Aid, Relief, and Economic Security (CARES) Act signed into law on March 27 included provisions that would waive the requirement that a Medicare
There are basic steps to follow when creating an effective contingency plan. In any crisis, emergency, or pandemic, which do happen from time to time,
The Centers for Medicare & Medicaid Services (CMS) has extended the deadline until May 1, 2020 to start using the new Important Message from Medicare
In an unprecedented move, the Centers for Medicare & Medicaid Services (CMS) has released 15 documents specifying new waivers in response to the COVID-19 pandemic.
Patients must continue to be discharged to an appropriate setting, per CMS. As hospitals continue in their struggle to treat patients for COVID-19, the illness
Federal authorities have decided that telephonic communications is an acceptable alternative to in-person meetings. EDITOR’S NOTE: With looming shortages of personal protective equipment (PPE) and
Long-awaited and highly anticipated, providers hope other payers will follow suit. Healthcare insurer giant UnitedHealthcare (UHC) has announced that it will be suspending prior authorization
Rural America is facing a healthcare crisis. EDITOR’S NOTE: The global pandemic of the coronavirsus is further exacerbating the rural health crisis. This is the
List of resources for front-line professionals. Everyone is coping with the new norm imposed by COVID-19, with those at risk for the social determinants of
CMS CRUSH (Comprehensive Regulations to Uncover Suspicious Healthcare) signals a new era of data-driven program integrity oversight that extends far beyond coding and CDI. As federal scrutiny of claims, documentation, billing practices, provider enrollment, and payment accuracy intensifies, healthcare organizations must be prepared to identify and address vulnerabilities before they result in audits, denials, repayments, or enforcement actions. Join us for this timely webcast to learn what CMS CRUSH could mean for your organization and discover practical strategies to strengthen documentation, claims integrity, compliance readiness, and reimbursement defensibility.
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.
Artificial intelligence is rapidly transforming healthcare revenue cycle operations, from coding and auditing to compliance and denials. Join industry leaders Pam Warren (MaineHealth) and Raemarie Jimenez (AAPC) for a live fireside chat exploring how AI is changing workflows, workforce roles, payer-provider dynamics, and compliance risk—and what organizations should be doing now to prepare.
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.
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