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
During the Jan. 11 Talk Ten Tuesdays broadcast, I talked about the five most expensive conditions and the clinical documentation integrity opportunities associated with them.
Oct. 1, 2016 brought a very large update to our ICD-10-CM coding system, as everyone is well aware. There were many new codes. Codes that
Comprehensive yet pertinent documentation is critical within the medical record. Beyond data and insight being shared among medical providers caring for a patient, good documentation
FEATURING Janelle Ali-Dinar, PhD; Nancy Beckley, MS, MBA, CHC; Frank Cohen, MPA; David Glaser, Esq.; Ronald Hirsch, MD, FACP, CHCQM; and Robin Zweifel, MT(ASCP)
I have heard that there will be no PQRS payment adjustments in 2017 because of a problem with the ICD-10 code update. Can you provide any information about this?
In the OPPS, I read about respiratory therapy services sometimes being “conditionally packaged.” What does this mean?
When will CMS implement its appropriate use criteria (AUC)?
I am trying to find information about the change in Medicare prices for drugs from 2016 to 2017. Can you provide this information?
For Medicare outpatients, how are blood products paid?
As a follow-up to last week’s question, what codes would be reported for moderate sedation used with TEE?
It’s business as usual at the Centers for Medicare & Medicaid Services (CMS) this week in the wake of a White House order issued Wednesday
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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