The proposed rule is designed to reduce red tape associated with enrollment in Medicaid and related programs. In a move that some might surmise as
EDITOR’S NOTE: CMS has published the Fiscal Year 2023 (Oct 1, 2022) final rules for Medicare payments. The major rule is, of course, the inpatient hospital
There are no new MS-DRGs in the Final Rule. The fiscal year (FY) 2023 Inpatient Prospective Payment System (IPPS) Final Rule, released by the Centers
Appeal rights appear much narrower than many expected. Earlier this year, a federal appeals court issued an opinion on Barrows v. Becerra, a long-running class
The proposed rule includes expansions to the Physician Payment Schedule as well as a focus on access to high-quality care. The Calendar Year 2023 Physician
The discounted drug program is viewed as vital for vulnerable populations. With all eyes on the U.S. Supreme Court, as pending landmark decisions on abortion
The enforcement arm of the federal health department has been busy, with more than 300 criminal enforcement actions in six months. Of any unsavory traits
The final rule is expected to be posted on the first Friday in August. The Centers for Medicare & Medicaid Services (CMS) has released the
As expected, the PHE was renewed another 90-days effective April 16th, 2022. “As a result of the continued consequences of the Coronavirus Disease 2019 (COVID-19)
The HHS Secretary and the President both issued statements pledging to do more for communities of color. “Of all the forms of inequality,” Dr. Martin
You have questions, we have answers. EDITOR’S NOTE: On Jan. 24, RACmonitor published a special bulletin authored by Dr. Hirsch on the manual changes to
Litigation is targeting the QPA, and its designation as the going rate for out-of-network providers. A number of provisions from the No Surprises Act took
Familiarize yourself with the dramatic 2023 changes to codes, coding guidelines and documentation requirements for evaluation and management (E&M) split/shared and incident-to services.
Dr. Ronald Hirsch breaks down significant 2023 changes to coding and billing requirements for hospital observation services, including new physician E&M coding rules.
Learn how to save your facility hundreds of thousands of dollars in repayments and fines by correctly following CMS requirements for implantable medical device credit reporting. We provide you with all the need-to-know protocols, along with the steps for correct compliance while offering best practices to implement a viable strategy in your facility.
During an exclusive RACmonitor webcast, healthcare attorney Knicole Emanuel will explain in simple, easy-to-understand language the peril of the coming overpayment audits and describe your legal defenses.
Do you struggle with selecting and appending the correct modifier for your medical claims? Join our must-attend webinar, “Mastering Modifier Usage: Preventing Denials and Ensuring Compliance” to reduce claim denials and improve your reimbursement rates.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2023 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Get access to important guidance on each of the AHA‘s 2023 ICD-10-CM/PCS Quarterly Coding Clinics with information-packed on-demand webcasts available shortly after each official publication.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s third quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Kay Piper reviews the guidance and updates coders on information in the AHA’s second quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s first quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Why should you be focused on SDOH data and ICD-10-CM Z codes? How can you integrate the capture of these elements into your workflows? Get guidance now — before new CMS assessment and reporting mandates take effect.
Set yourself up for appeal success with knowledge about the legitimate presentations of acute heart failure, the common vulnerabilities that auditors identify, the challenges clinical teams face, and how to write a concise and compliant validation query.
What are the changes to the IPO and ACS lists for 2023? What auditor trends do you need to watch out for in the new year? Don’t be caught off guard. Register today for this essential regulatory update led by Dr. Ronald Hirsch.
Take away tried-and-true strategies for ensuring that your Utilization Review committee is working effectively
A massive task lies ahead! Now’s the time to start preparing your case management and utilization review teams for successful implementation of changes contained in the 2023 IPPS, OPPS and MPFS rules.
Learn how to achieve complete, accurate documentation that establishes medical necessity and how to differentiate between billable and non-billable services.
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