Despite vigorous protests by Senate Democrats, the U.S. Senate today confirmed President Trump’s nomination of Rep. Tom Price (R-Ga.) to helm the U.S. Department of
To quote Robert F. Kennedy, “There are those that look at things the way they are, and ask ‘why?’ I dream of things that never
Sept. 10, 2004 was a day of mixed blessings in the case management world. On that day, the Centers for Medicare & Medicaid Services (CMS)
EDITOR’S NOTE: A 9th Circuit Court of Appeals has yet to issue a decision on the federal government’s request to lift a district court judge’s
Durable medical equipment (DME) suppliers have a target on their backs. It is likely that they are subjected to the most frequent audits of any
Now that the new presidential administration has taken office, we can expect some modifications to the Medicaid program as an entitlement arrangement. Currently, everyone who
With millions of rural Americans at risk of losing health insurance and direct access to care, an unprecedented number of National Rural Health Association (NRHA)
EDITOR’S NOTE: This is the second and final installment in a two-part series on OB coding. Part I appeared in the Jan. 31, 2017 edition of ICD10monitor
Correction: Hierarchical Condition Categories (HCCs) have been a part of our coding, documentation, and reimbursement landscape since their implementation by Medicare in 2004. HCCs were
Approximately three million people suffer from glaucoma in the United States. There is no cure at the present time, but there are treatment options. The
FEATURING Janelle Ali-Dinar, PhD; Nancy Beckley, MS, MBA, CHC; Emily Evans; David Glaser, Esq.; Ronald Hirsch, MD, FACP, CHCQM; and J. Paul Spencer, CPC, COC
With millions of rural Americans at risk of losing health insurance and direct access to care, an unprecedented number of National Rural Health Association (NRHA)
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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