There are basic steps to follow when creating an effective contingency plan. In any crisis, emergency, or pandemic, which do happen from time to time,
In an unprecedented move, the Centers for Medicare & Medicaid Services (CMS) has released 15 documents specifying new waivers in response to the COVID-19 pandemic.
Long-awaited and highly anticipated, providers hope other payers will follow suit. Healthcare insurer giant UnitedHealthcare (UHC) has announced that it will be suspending prior authorization
Rural America is facing a healthcare crisis. EDITOR’S NOTE: The global pandemic of the coronavirsus is further exacerbating the rural health crisis. This is the
List of resources for front-line professionals. Everyone is coping with the new norm imposed by COVID-19, with those at risk for the social determinants of
Testing a limited number of random people, we can reach conclusions within a certain probability. Statistical analysis is a funny thing. It turns out that
Not all waivers are created equal. Last week’s article briefly discussed the Emergency Medical Treatment & Labor Act (EMTALA). Here is a more detailed discussion. The legal
EDITOR’S NOTE: Dennis Jones is the Administrator of Patient Financial Services for Montefiore Nyack Hospital in Nyack, N.Y., about 20 miles north of New York
March 23, 2020—The Centers for Medicare & Medicaid Services (CMS) has clarified its position on the use of swing beds, saying that swing beds can
The regulatory landscape is rapidly changing in the wake of the coronavirus. EDITOR’S NOTE: As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president
The uncomfortable truth about the coronavirus pandemic? A near-total and indefinite shutdown of American life is probably just the beginning. EDITOR’S NOTE: Veteran RACmonitor
On March 13, the Centers for Medicare & Medicaid Services (CMS) issued blanket waivers that will impact Inpatient Rehabilitation Facilities (IRFs) as well as other
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.
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.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
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.
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