The announcement aligns with the Biden Administration’s push to emphasize health equity through policy. Federal officials have issued a final rule for Medicare Advantage (MA)
Moral injury is the sequela of distressing, psychological, behavioral, social, and spiritual aftermath of these tough decisions. The COVID-19 pandemic has posed significant challenges for
The proposed rule delays for another year it’s implementing a comprehensive CC/MCC restructuring that the agency had proposed four years ago. Since the latter part
RACmonitor readers have been listening to Monitor Mondays for years, since 2010 in fact. And listeners are very familiar with the host of the show,
Can you clarify whether a screening mammogram or a diagnostic mammogram should be performed on an asymptomatic patient with augmented breasts (e.g., breast implants)?
What is the update for local clinical laboratory fees in 2022? What is the national minimum payment amount?
Are there any limitations to pulmonary function studies that we should be aware of?
What is included in 0644T?
To be productive, we must visualize the outcomes we want. EDITOR’S NOTE: This is a transcript of Dr. Zelem’s segment during Talk Ten Tuesdays recently. Marcela
Is it a worthwhile or reliable means to gather information? EDITOR’S NOTE: Jason Henninger is the managing editor and product manager at MedLearn Media. Making
The case, which arose on April 1, demonstrates an exhaustion of administrative remedies. In Guidry v. CMS, Guidry was a pro se medical doctor. This
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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