Should hospitals combine two admissions into one? In the absence of CMS guidance, hospitals are urged to do the right thing. Last week I wrote
Whistleblower suits target insurer titan. It’s been a busy couple of weeks for at least one of the two whistleblower cases proceeding against UnitedHealth Group
The struggle continues to foster understanding that compliance is linked to care. Essentially every physician advisor entered the field of medicine to cure ailments, alleviate
Mental health diagnoses offer possible insight into the mind of suspected Las Vegas mass murdered Stephen Paddock. EDITOR’S NOTE: The following are remarks by nationally
Electronic medical record (EMR) technology offers both advantages and pitfalls, but EMR errors must be investigated nonetheless. EDITOR’S NOTE: In this article Dr. John Irwin,
Complexity of medical decision-making is key, but you can’t bill for something you didn’t do. This article was prompted by a Talk Ten Tuesdays listener’s
The American Hospital Association steps in; the American Medical Association steps up. On Sept. 27, 2017, the Centers for Medicare & Medicaid Services (CMS) announced
We are hearing a lot lately about something known as DIR. Does this apply to Medicare?
What is the best code to assign for a generator change from a dual-chamber to a single-chamber? Our cardiologist capped off a lead and then replaced a dual-chamber with a single-chamber pacemaker.
How should a split-night study be coded? Can the diagnostic portion and titration portion of a single study be billed separately?
What does PAMA specifically say about CLFS payment rate decreases? I know that CMS has proposed reductions for 2018, and I just wonder how these comply with the original law.
What is the Medicare Open Payments program?
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
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