One Quality Improvement Organization (QIO) gave the wrong information, costing a hospital thousands of dollars. First, let me thank all of you who have been
Understanding precisely what the phenomenon of “ED boarding” means is vital to managing proper placement of patients. I was recently asked by Christine in Minnesota
CMS issued the Program Audit Process that sets forth rules auditors must abide by in 2023. The 2023 Program Audit Process Overview from the Centers
The federal agency announced this week that it has updated its policies for the MA RADV program. Echoing an intensifying drumbeat of criticism heard from
The Centers for Medicare & Medicaid Services (CMS) told us last week that: “We have made significant progress in decreasing the inappropriate use of antipsychotic medications
CMS is simply proposing to codify what is currently CMS policy. I was wrong. There, I said it. And I extend a heartfelt apology to
CMS proposes new rules for 2024 that apply to Medicare Advantage Plans. Last month, I told you that there would be big news coming, and
New deductibles and payment rates lead to new patient financial obligations for 2023. EDITOR’S NOTE: Listen to Dr. Ronald Hirsch’s live reporting Monday on Monitor
Proposal also seeks to increase information to patients. New proposals to improve the prior authorization process, while giving patients information on the status of prior
It’s more than just a matter of time. I have discussed many times on Monitor Mondays the controversial Food and Drug Administration (FDA) accelerated approval
CMS is enforcing its rule with penalties. The Centers for Medicare & Medicaid Services (CMS) is focusing new funding and efforts on hospital price transparency
The anticipated issue date for the new audit is the 2024 fiscal year. Citing “consistently high error rates,” federal officials announced this week that
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.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s third quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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