Clinics that provide MRI, CT, or PET scans and health systems that employ physicians and would consider compensating a physician in part for work done
Inpatient rehabilitation facilities (IRFs) continue to face audits for multiple agencies, and additional documentation requests (ADRs) have become routine rather than the exception. In our
Monday, March 6, 201710-10:30 a.m. EST; 7-7:30 a.m. PST SPECIAL GUESTStanley Sokolove, CPA, ALJ Emeritus ALSO FEATURINGJanelle Ali-Dinar, PhD; Nancy Beckley, MS, MBA, CHC;
With the March 8 deadline to implement the Centers for Medicare & Medicaid Services (CMS) Medicare Outpatient Observation Notice (MOON) bearing down on providers, Wednesday’s
SPECIAL GUEST Marc Tucker, DO FEATURING Janelle Ali-Dinar, PhD; Nancy Beckley, MS, MBA, CHC; David Glaser, Esq.; Ronald Hirsch, MD, FACP, CHCQM; and J. Paul
What does a doctor or other provider know about clinical documentation and integrity? What does a surgeon know? Why is it important? How do surgeons
It’s been a year since the “sepsis-3” definition was released at the Society of Critical Care Medicine (SCCM) meeting and concurrently published in the Journal
EDITOR’S NOTE: What follows is the second piece of a two-part series examining how health risk, severity, and complexity impact healthcare policy, payment, and quality
The American Society of Nuclear Cardiology recommends nuclear medicine imaging code 78803 or 78800 with A9538 (for PYP) for patients with cardiac amyloidosis. Would either of the 788XX codes above be the correct CPT for this exam?
What is the difference between the Tier 1 and Tier 2 molecular pathology CPT codes?
What biosimilars have been approved by the FDA, and how are they coded?
If a different physician or physician group is doing the nuclear medicine study on the same day, can an interventional radiologist bill anything for the injection of MAA [technetium tc-99m macroaggregated albumin]?
CMS CRUSH (Comprehensive Regulations to Uncover Suspicious Healthcare) signals a new era of data-driven program integrity oversight that extends far beyond coding and CDI. As federal scrutiny of claims, documentation, billing practices, provider enrollment, and payment accuracy intensifies, healthcare organizations must be prepared to identify and address vulnerabilities before they result in audits, denials, repayments, or enforcement actions. Join us for this timely webcast to learn what CMS CRUSH could mean for your organization and discover practical strategies to strengthen documentation, claims integrity, compliance readiness, and reimbursement defensibility.
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.
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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