Latest surge cited as reason for delays. Hospitals continue to experience challenges from the latest wave of COVID patients; over 750,000 patients were hospitalized last
UHC ordered to refund payment within 60 days. On Aug. 13, the U.S. Court of Appeals for the District of Columbia ruled in UnitedHealthcare Insurance
Providers offering the shot to multiple residents in one home setting or communal setting will now be eligible for multiple boosted payments. Federal officials are
Vaccine mandates expand; transparency faces new lawsuit The U.S. Department of Health and Human Services (HHS) has ordered its healthcare employees to get the COVID
Life at the intersection of the latest Census Report and SDoH. There was tremendous buzz last week about the U.S. Census report on shifting demographics
When considering coding protocols, it’s vitally important to differentiate between “requirements” and “recommendations.” In June I did a Monitor Mondays segment and a RACmonitor article
Survey data suggests that hospital executives, physician advisors, and case managers are not always on the same page. Sound Physicians‘ recent nationwide survey provides insights
The legal decision could have ramifications to the tune of tens of billions of dollars. A unanimous opinion by the Washington, D.C. Circuit Court of
What to do with the proposed rule – adopt, wait, adapt? After years of suggestions from various parties, the Centers for Medicare & Medicaid Services
EDITOR’S NOTE: In the current e-news edition of RACmonitor, Chris Gallaher, a coder, takes issue with a June 23 article written for RACmonitor by healthcare
EDITOR’S NOTE: This article is in rebuttal to an article written for RACmonitor by David Glaser, Esq. on June 23, 2021. A recent article in
Depending on the clauses, contracts can be your worst enemy or your savior. Today I pose a very important question to you. Do your participation
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.
This Memorial Day, we honor those who gave all for our freedom. Take 20% off sitewide through May 29 with code MEMORIAL26 at checkout
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
