How do you refer to the Social Determinants in your organization?
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CMS is encouraging the integration of healthcare providers so that their size is increased to have averaged payments represent a break-even or better. CMS (the
Providers should consider how to optimize the patient’s health status prior to discharge to hospice. In his RACmonitor article of Aug. 8 regarding the recent
In FY 2019, hospital performance in the HRRP will be assessed relative to hospitals within the same peer groups. Since 2013, Medicare has penalized hospitals
2019 IPPS removes requirement for authentication of admission orders prior to discharge. EDITOR’S NOTE: This is the second and final installment of a two-part series.
CMS provides Medicare waivers for providers dealing with natural disasters. I live in North Carolina, and as most of you have seen on the news,
A healthcare professional’s natural disaster survival guide. Editor’s Note: Dr. Zirkman, Chief Medical Advisor for CarolinaEast Medical Center, spent the last week preparing for and
Accounting for socioeconomic factors is critical to the sustainability of healthcare. Editor’s Note: This article was written as Hurricane Florence was heading directly for the
CMS continues to help hospitals impacted by the aftermath of Florence No sooner had Monitor Monday signed off on Monday’s program with live reports from
2019 IPPS removes requirement for authentication of admission orders prior to discharge. EDITOR’S NOTE: This is the first installment of a two-part series. When the
RAC issue for IRFs has moved from being proposed to being approved. The Centers for Medicare & Medicaid Services (CMS) recently posted a potential Complex

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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