Where a procedure is performed or a service is delivered can have an impact on how much the Centers for Medicare & Medicaid Services (CMS)
EDITOR’S NOTE: President Trump’s pick for Secretary of Health and Human Services Rep. Tom Price, (R-Ga.) came under intense scrutiny during Senate confirmation hearings on
FEATURING Janelle Ali-Dinar, PhD; Nancy Beckley, MS, MBA, CHC; David Glaser, Esq.; Ronald Hirsch, MD, FACP, CHCQM; Michael Rosen, Esq.; J. Paul Spencer, CPC, COC;
The first day of school. The first day of a new job. Both tend to come with jitters and apprehension. Yesterday marked the first Monday
With the inauguration of Donald Trump as the 45th U.S. president getting underway this morning in Washington, D.C., 30 percent of healthcare professionals believe that
Because the healthcare world is so highly regulated, assertions that you “must” or “can’t” perform a particular action are common. Because the penalties for legal
With more and more health information being stored and transmitted electronically, the demand for easier access to protected health information (PHI) has grown dramatically of
EDITOR’S NOTE: This is the first in a two-part series on the state of rural healthcare in America. In part two, the author will report
Effective Jan. 17, 2017, the Centers for Medicare & Medicaid Services (CMS) published a final rule titled Medicare Program: Changes to the Medicare Claims and
Compliance and fines are two things that go together in healthcare. The environment for imposing those fines and issuing exclusions for individuals or companies that
FEATURING Janelle Ali-Dinar, PhD; Nancy Beckley, MS, MBA, CHC; Bret Bissey, MBA, FACHE, CHC, CMPE; William Dombi, Esq.; Sara Goldstein, Esq.; Ronald Hirsch, MD, FACP,
For those compliance officers and leaders looking for another way to educate or influence their colleagues and decision-makers about the need for proactive and effective
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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