HRSA claims delay will have no impact on current stakeholders. The Health Resources and Services Administration (HRSA), which administers Section 340B of the Public Health
Misinformation abounds in wake of execution of search warrants. The recent raid on President Trump attorney Michael Cohen’s office has brought much discussion about the
The scoring mechanisms of the MDM are suggested tools, not rules or laws. In our last article we explored how time in conjunction with medical
Level of care is increasingly becoming a source of payer utilization review denials It was widely recognized after the Centers for Medicare & Medicaid Services
Those involved in compliance will want to keep tabs on these changes with due concern. The Bipartisan Budget Act of 2018 (BiBA) was signed into
Providers must document the complexity of care for each and every patient. There is a standard misunderstanding of the utilization of time-based documentation and billing.
At the heart of underusing palliative care is that no person wants to inflict sadness on another. Among the synonyms for the adjective ‘brutal’ are
The promise of patients over paperwork may greatly benefit hospitals. The Centers for Medicare & Medicaid Services (CMS) has posted the 2019 Inpatient Prospective Payment
There are now 200,000 new targets for CMS and private payers. Since the first of this year, I have engaged in several audits for which
I am changing my interpretation of the final rule with help from the trenches. Often referred to as the “carpenters” of medicine, orthopedic surgeons are
CMS has created a giant loophole that continues to perplex. I get a lot of questions about status changes. To explain how even the seemingly
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
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.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
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.
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