OIG report shines spotlight on area of confusion for billing. In a recent report, the U.S. Department of Health and Human Services (HHS) Office of
Every patient receiving an ICD for primary prevention will be required to have an encounter for shared decision-making using an evidence-based decision tool. The Centers
The whole world of opt-out physicians and practitioners creates compliance issues, particularly for coding, billing, and reimbursement Physicians and certain practitioners can elect to opt
The CERT study gives one the opportunity to identify potential errors the same way that the auditors do. With nearly a million physicians in this
A recent False Claims Act case highlighted a range of perils. Scripps Hospital recently paid $1.5 million to resolve a False Claims Act (FCA) case. There
The court ruled that the whistleblower’s complaint lacked credible allegations that any false claims were submitted to Medicare. Last week, a federal Judge in the
An analysis of your peer-to-peer process might lead to your abandoning the program. The peer-to-peer (P2P) process is a particularly abhorrent chore for physicians. These
With the purchase of Aetna, CVS hopes to steer patients enrolled in Aetna’s insurance plans from hospital outpatient clinics and go directly to clinics located
A look ahead to the unification of healthcare and how patients access their information. It has been announced that Apple is expanding its HealthKit application
Pending a possible government shut down, this bill would allow documentation from a home health agency to be considered when records are reviewed. Late on
A False Claims Act case pits a prominent health system against its EHR software provider. Over the last many years, healthcare providers have been financially
Relationships with drug and device companies come with risk. Fortunately, the risk is manageable by using common sense to structure payments. Imagine you’re in a
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
This second session in our 2026 IPPS Masterclass will feature a review the FY26 changes to ICD-10-PCS codes. This information will be presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
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