Gabby Nunez from Community Memorial Health System in Ventura, Calif. recently asked the RAC Relief user group about the patient who insists on being admitted
Who complained? That might seem like a totally reasonable question. But it’s something that compliance officers might want to discourage from being asked. The issue
EDITOR’S NOTE: As congressional Republicans and the Trump administration grapple with challenges associated with their efforts to repeal and replace the Patient Protection and Affordable
The Centers for Medicare & Medicaid Services (CMS) will be changing the criteria for short-stay audits in April, according to KePRO, one of the Medicare
The American Health Care Act (AHCA), which was introduced to Congress on March 7 as a repeal and replacement of the Patient Protection and Affordable
Section 6411(b) of the Patient Protection and Affordable Care Act of 2010 (PPACA) requires the expansion of the Recovery Audit Contractor (RAC) program to Medicare
EDITOR’S NOTE: Matthew Albright will be the special guest on the March 27 edition of Monitor Mondays. Register now!This story was posted on Tuesday in
With unusual bipartisan support, a new piece of legislation of about 1,000 pages was signed into law on Dec. 13, 2016 – the 21st Century
Monday, March 20, 201710-10:30 a.m. ET; 7-7:30 a.m. PT SPECIAL GUESTLarry Field, DO, MBA, CHCQM, CPC, CHC, LHRMAmerican College of Physician Executives ALSO FEATURINGDuane Abbey,
Since it was put into place back in 2013, most of us have managed to grasp the specifics of the Medicare two-midnight rule. Whether there
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a mystery to many. Sent to hospitals as an Excel workbook, I find it to
The word “stoned” is a 1960s slang word meaning roughly “intoxicated on illegal drugs.” The United States currently has an opioid epidemic. It has grown
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
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