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
Yes, notes needn’t stand alone. Sometimes two contradictory principles work their way into conventional wisdom. I often hear people say, “Every note must stand alone.” Is
It’s important to remember that Medicare manuals are not binding, and they can’t “require” anything, including signatures. A few weeks ago, I wrote an article
All diagnoses should be clinically valid. Denial of reimbursement for medical care occurs for a multitude of reasons, including incomplete or inaccurate information, lack of
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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