When the Centers for Medicare & Medicaid Services (CMS) formalized CMS-4201-F with an effective date of Jan. 1, 2024, there was great relief within the
The voices calling out for a “patient-centric care model” are either rapidly fading or are being drowned out by the noises of poor payment, preauthorization,
How often have you heard, when getting Medicare data, “that does not include Medicare Advantage (MA) data in that report.” MA, now representing over 50
Just before Congress adjourned for 2023, lawmakers sent another in a series of letters to the Centers for Medicare & Medicaid Services (CMS) expressing “serious
In the 2023 Fourth Quarter of the American Hospital Association (AHA) Coding Clinic, there is discussion of two types of short-term external heart assist systems.
The U.S. Office of Minority Health (OMH) released last Tuesday new public files on Socio-demographic and Health Characteristics of Medicare Beneficiaries Living in the Community
The Biden Administration has announced that it is poised to begin collecting feedback regarding proposed sweeping changes to the growing Medicare Advantage (MA) marketplace, marking
A new code, recently announced by the Centers for Medicare & Medicaid Services (CMS), is effective now and according to some it’s expected to keep
What considerations should be taken into account when coding for the imaging of the inferior phrenic artery, especially concerning the various anomalous arterial variations that may exist, including different points of origin such as the aorta, celiac, or renal artery?
Do you have any tips for respiratory therapy rehabilitation in 2024?
How do we report multiple percutaneous image-guided breast biopsies in 2024?
Can you explain some of the rationale behind new 2024 chemistry codes 86041-43, and 86366?
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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