Some recent high-profile cases clearly demonstrate neglect, fraud, and abuse. While not new, private equity (PE) interests are buying hospitals and skilled nursing facilities (SNFs)
The case of convicted former nurse RaDonda Vaught has created a cascade of opinions but are the experts right? Let’s consider a scenario: A 30-year-old
With the resumption of CERT, a primer is provided because soon you will be receive request for records. After a hiatus during the Public Health
Five steps to mitigate the effects of burnout are offered. It is April, and we are just starting the second quarter of 2022. Does anyone
The impact is expected to be felt for years to come. Three years into the global pandemic and health systems remain stretched to the breaking
CMS issues proposed payment rules for inpatient rehab facilities, psychiatric care and hospice-based payments. EDITOR’S NOTE: Stanley Nachimson, a former CMS career professional, now an
Sticker shock no more. Today I will be giving you my point of view on the No Surprises Act – a topic of great interest
Try your best to tamp down your instinctive fear of change. EDITOR’S NOTE: Elizabeth Lamkin is the former CEO/Market President for Tenet Healthcare’s Hilton Head
Talk Ten Tuesday’s cohost accepts an invitation to be a guest on an Australian’s podcast series. Have you ever played Six Degrees of Kevin Bacon?
A little snow can make for a big day in Southern California. PUBLISHER’S NOTE: Photo provided by Marvin D. Mitchell EDITOR’S NOTE: Marvin Mitchell is
Both initiatives speak to patient-centric care. EDITOR’S NOTE: Stanley Nachimson, a former CMS career professional, is a popular presenter on Talk Ten Tuesdays. The Accountable
Science fiction and medicine meet in artificial intelligence. EDITOR’S NOTE: Jason Henninger is the managing editor and product manager at MedLearn Media. I’ve always been
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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