The recent Republican budget proposal has sparked heated debate over its projected impact on Medicaid, with Democrats arguing it cuts as much as $880 billion
A recent analysis of 5 billion claims from a sampling of providers found that total at-risk dollars from payer audits were five times higher in
Today I have a topic that is quite practical and applicable to the everyday work of readers. Many have discussed the power of our words.
The No Surprises Act (NSA) law continues to dominate the news yet again. While we’re not expecting any imminent sweeping overhauls of the law, we
Written in March 2013 by the highly respected Dr. Steven Meyerson, “Observing the Rules for Observation after Outpatient Surgery” evolved over time into one of
The new CPT® books are out, and they include a discussion about shared visits. Pamela Schulman (a Monitor Mondays listener) asked a great question: “How
Today, I want to talk about secret, hidden RAC audits. As you are probably aware, federal regulations limit RACs from going back more than three
When I first read the recent U.S. Supreme Court decision in U.S. ex rel. Schutte v. Supervalu I found the decision both troubling and very
A colleague of mine recently asked, “what does it take for a doc to get sent to prison?” I had to confess: I really didn’t
Last week, the Centers for Medicare & Medicaid Services (CMS) gave itself a very bad report card on how it did during the first year
As you may know, several payers have adopted a policy that they will review hospital billing for facility fees for emergency department visits, and will
The drug data report is a requirement of the No Surprises Act. The No Surprises Act (NSA) requires the collection and reporting of the prescription
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
Fraud convictions don’t just punish a few bad claims; they can wipe out years of reimbursements. Don’t wait for an audit to learn the rules. Join Frank Cohen, MPA, for a live Q&A on spotting red flags, avoiding liability, and protecting your practice. Register now and bring your questions!
Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025. Register today and be a part of the conversation!
Vaccine policies, billing rules, and compliance risks are changing fast! How will your organization adapt? Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating new Medicare mandates, coding updates, and legal challenges in vaccination programs. Get expert answers on billing, compliance, outbreak risks, and operational strategies to protect your facility and patients. . Join us live and bring your questions to the table.
Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals. Don’t miss this chance to protect your hospital’s revenue and reputation!
Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!
Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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