The No Surprises Act’s Independent Dispute Resolution process – deemed clunky by some – appears to be swamping the HHS system. The No Surprises Act
Hospitals are vulnerable to tragedies. EDITOR’S NOTE: Dr. John Zelem, a physician advisor for three community hospitals, shares his thoughts on the tragedy that struck
During the last several months, the federal government has been siding with healthcare providers in an all-out assault on the prior authorization process, which requires
The funding comes with a particular focus on the provision of mental health services. Amid rising concerns over mental health issues affecting juveniles, federal officials
Physician advisors can serve as a trusted resource for any EMTALA concerns.
HHS is taking steps toward ensuring a smooth transition out of a 39-month period of uncertainty.
Lawsuits, congressional attention, and recent reports are all focused on the same unifying topic. This probably comes as no surprise to read, but during the
The program aims to lower drug costs and improve affordability for Americans with Medicare. The Centers for Medicare & Medicaid Services (CMS) has released initial
The GAO cites deficiencies in the HHS program’s response to past PHEs. Just last week, the Government Accountability Office (GAO) took a significant step by
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
There appears to be a general lack of awareness concerning the value rural hospitals bring to a community. Over the upcoming weeks I will be
Familiarize yourself with the dramatic 2023 changes to codes, coding guidelines and documentation requirements for evaluation and management (E&M) split/shared and incident-to services.
Dr. Ronald Hirsch breaks down significant 2023 changes to coding and billing requirements for hospital observation services, including new physician E&M coding rules.
Learn how to save your facility hundreds of thousands of dollars in repayments and fines by correctly following CMS requirements for implantable medical device credit reporting. We provide you with all the need-to-know protocols, along with the steps for correct compliance while offering best practices to implement a viable strategy in your facility.
During an exclusive RACmonitor webcast, healthcare attorney Knicole Emanuel will explain in simple, easy-to-understand language the peril of the coming overpayment audits and describe your legal defenses.
Do you struggle with selecting and appending the correct modifier for your medical claims? Join our must-attend webinar, “Mastering Modifier Usage: Preventing Denials and Ensuring Compliance” to reduce claim denials and improve your reimbursement rates.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2023 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Get access to important guidance on each of the AHA‘s 2023 ICD-10-CM/PCS Quarterly Coding Clinics with information-packed on-demand webcasts available shortly after each official publication.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s third quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Kay Piper reviews the guidance and updates coders on information in the AHA’s second quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s first quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Why should you be focused on SDOH data and ICD-10-CM Z codes? How can you integrate the capture of these elements into your workflows? Get guidance now — before new CMS assessment and reporting mandates take effect.
Set yourself up for appeal success with knowledge about the legitimate presentations of acute heart failure, the common vulnerabilities that auditors identify, the challenges clinical teams face, and how to write a concise and compliant validation query.
What are the changes to the IPO and ACS lists for 2023? What auditor trends do you need to watch out for in the new year? Don’t be caught off guard. Register today for this essential regulatory update led by Dr. Ronald Hirsch.
Take away tried-and-true strategies for ensuring that your Utilization Review committee is working effectively
A massive task lies ahead! Now’s the time to start preparing your case management and utilization review teams for successful implementation of changes contained in the 2023 IPPS, OPPS and MPFS rules.
Learn how to achieve complete, accurate documentation that establishes medical necessity and how to differentiate between billable and non-billable services.
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