Certainly, audits are a growing source of concern, but there is no need for panic if you are adequately prepared. The topic of audits has
What care management needs to know, and how health systems can start preparing. On July 1, the Centers for Medicare & Medicaid Services (CMS) released
Demonstrate that a service was provided, and the absence of documentation typically is not relevant. I was recently contacted by a clinic that is in
Providers seeking to get ahead of the curve before the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Final Rule for
EDITOR’S NOTE: Former CMS official Matthew Albright, now a legislative consultant for Zelis and a RACmonitor contributor and Monitor Monday’s panelist, will continue his reporting
From LOS to CC 44 and the Pepper Report, important news, and updates. Last week was (thankfully) a boring regulation week. So instead of working
The No Surprises Act takes effect on January 1, 2022 On Dec. 27, 2020, President Donald Trump signed the longest law in the history of
Strategies for increasing revenue and litigating on behalf of clients. There are two ways to increase revenue merely by ensuring that your patients’ rights are
Medicaid is a safety net for millions of people. The numbers have been all over the media this past week: More than 80 million people
Hospitals are advised to offer choice to patients in terms of nursing homes, home care agencies, long-term acute-care hospitals, and inpatient rehabilitation facilities. It has
The Patient Protection and Affordable Care Act survives another suit. Last week, the U.S. Supreme Court released its decision on Texas v. USA, the latest
Recent conference reveals proposed legislation focused on the social determinants of health. Last week I got a bird’s eye view of all that is happening
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
