An Egregious Piece of Misinformation from a MAC
NGS needs to retract its wildly inaccurate instructions about split and shared visits. A client recently reached out to me trying to understand whether it
NGS needs to retract its wildly inaccurate instructions about split and shared visits. A client recently reached out to me trying to understand whether it
From think tanks to federal agencies, health policy in the U.S. is often shaped by voices we don’t always see in the headlines. Abe Sutton,
Normally, I write about substantive law, but today I’m going to focus more on psychology. The idea was triggered by the subject line in an
As you may recall, last week I critiqued a webinar on the two midnight rule. As you will recall it was not pretty. Today I
As you may recall, last week I defended two payers that faced unwarranted outrage on social media. But if you read my Thursday article, you
Last week, one of my clients got a letter from a state Attorney General. The letter requested information about two of the organization’s former employees.
EDITOR’S NOTE: This is the third in a multi-part series on the Comprehensive Error Rate (CERT) study in which senior healthcare analyst Cohen describes how
Today I want to write about one of our current hot-button topics: artificial intelligence, better known as AI. First, I want to pose the question:
Sometimes, life is predictable. Eclipses are a great example. (You should plan on seeing the next total solar eclipse, on April 8, 2024! It’ll be
Physician advisors can serve as a trusted resource for any EMTALA concerns.
CMS has implemented two measures under its Hospital Inpatient Quality Reporting program. There is a lot of buzz in the Social Determinants of Health (SDoH)
New changes impact the ADR limits for RACs. The Centers for Medicare & Medicaid Services (CMS) has modified the additional documentation request (“ADR”) limits for

Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.

During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.

Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.

RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.

Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.

Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.

Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.

This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
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