Testing a limited number of random people, we can reach conclusions within a certain probability. Statistical analysis is a funny thing. It turns out that
Not all waivers are created equal. Last week’s article briefly discussed the Emergency Medical Treatment & Labor Act (EMTALA). Here is a more detailed discussion. The legal
EDITOR’S NOTE: Dennis Jones is the Administrator of Patient Financial Services for Montefiore Nyack Hospital in Nyack, N.Y., about 20 miles north of New York
March 23, 2020—The Centers for Medicare & Medicaid Services (CMS) has clarified its position on the use of swing beds, saying that swing beds can
The regulatory landscape is rapidly changing in the wake of the coronavirus. EDITOR’S NOTE: As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president
The uncomfortable truth about the coronavirus pandemic? A near-total and indefinite shutdown of American life is probably just the beginning. EDITOR’S NOTE: Veteran RACmonitor
On March 13, the Centers for Medicare & Medicaid Services (CMS) issued blanket waivers that will impact Inpatient Rehabilitation Facilities (IRFs) as well as other
EDITOR’S NOTE: This is a developing story subject to change. The goal of both state governments and Congress last week was to remove any economic
Federal officials have been making efforts to ease restrictions and waive requirements in a time of crisis. The Centers for Medicare & Medicaid Services (CMS)
Overzealous and hyper-aggressive audit tactics are scaring providers away from self-governing. The U.S. Department of Health and Human Services (HHS) strikes again, and this time,
The nation’s largest city saw its cases soar past the 1,000 mark this week. I wish that I was writing under better circumstances, but these
Vulnerable seniors, especially those with underlying health conditions, have been of particular concern to those working to stem the coronavirus pandemic. Federal authorities have rolled
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.
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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