The distinction is semantic: recommendations versus required. It can be easy to lose sight of the difference between a “recommendation” and a “requirement.” But the
The case was brought by the data analysis firm Integra Med Analytics. Moore’s law, the concept that the cost of storing data falls by half about
A third of unvaccinated Americans were unsure if their insurance covered the vaccine. The Coronavirus Aid, Relief, and Economic Security (CARES) Act passed last spring
Important advice when dealing the media. Because the federal government and health insurers are covering the cost of the COVID-19 vaccine and its administration, it
FDA approval of the new Alzheimer’s drug appears to be raising new questions and concerns. The soaring cost of new medications and technologies is not
The Biden Administration is turning its attention to the approximately 1.6 million seniors covered by Medicare who experience difficulty leaving their homes. The federal government
Judge’s order prevented closing of mental health clinic. Last week, I won a permanent injunction for a healthcare facility that, but for the injunction, would
Actions speak louder than words. Several impactful events occurred in the arena of the social determinants of health (SDoH) over these past few weeks. The
Medicare reimbursement is merely one of a plethora of reasons that medical record documentation is important. Last week Frank Cohen wrote an excellent article exploring
Without detailed documentation, providers may face an uphill battle in defending themselves from quality audits and even malpractice issues. Up until 2021, at least for
The most recent CDC guidance on masks is again, just guidance. If you’re like me, you went out this past weekend to Home Depot or
In-person hearings are back – at least in most states. 2020 was an odd year for Recovery Audit Contractors (RACs) and Medicare Administrative Contractors (MACs).
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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