The case, which arose on April 1, demonstrates an exhaustion of administrative remedies. In Guidry v. CMS, Guidry was a pro se medical doctor. This
The plan includes a goal to improve maternal health outcomes. Federal officials currently engaged in a prolonged push to address health disparities across the U.S.
With every proposed test there must be an evaluation of the potential benefit, but also the risk: every test has risks. Today’s topic was inspired
With Medicare regulations, there appears to be no right answer. A recent discussion on an Internet user group asked the question, “is there any wiggle
Hospitals need a cross-functional approach that views each department as a key component within the clinical revenue cycle that drives overall financial performance and regulatory
The for-profit payer business model is, at its core, simple math. The goal is to make a profit for investors/owners. In the first article of
The Health Resources and Services Administration, however, did received $1 billion for programs to improve maternal and child health. Congress passed a $1.5 trillion spending
The president’s initiative on mental health would require insurers to cover three mental health visits a year, at no cost to members. President Joe Biden
Medicare Advantage plans are being buffeted by bad news and regulatory challenges. Last week produced a lot of Medicare Advantage (MA) news. Retired municipal workers
Latest lawsuit is one of four targeting the controversial legislation. Oral arguments were heard a little over a week ago on the Texas Medical Association
New initiatives capture attention on Capitol Hill. New this week: the rebirth of one sweeping health policy, the presumed death of another, and a hint
Ownership questions persist and remain controversial. Recently we have been involved in several discussions regarding who “owns” the chart: the medical record. I really didn’t
Medicare regulations are complex and even seasoned professionals struggle to apply them consistently. Due to overwhelming demand, Dr. Hirsch returns for Part 2 of Ask Dr. Hirsch: Clarifying Medicare’s Most Misunderstood Rules to answer even more of Medicare’s most misunderstood questions, covering inpatient status, observation, SNF access, Medicare Advantage denials, and more. Join Dr. Hirsch as he provides clear, referenced answers to real-world questions submitted by your peers, helping you navigate Medicare compliance with confidence and clarity.
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.
Artificial intelligence is rapidly transforming healthcare revenue cycle operations, from coding and auditing to compliance and denials. Join industry leaders Pam Warren (MaineHealth) and Raemarie Jimenez (AAPC) for a live fireside chat exploring how AI is changing workflows, workforce roles, payer-provider dynamics, and compliance risk—and what organizations should be doing now to prepare.
Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
Stay ahead of FY 2027 reimbursement changes with expert analysis of MS-DRG shifts, NTAP updates, Medicare Code Edits, and emerging technologies impacting inpatient payment accuracy.
Stay ahead of FY 2027 ICD-10-PCS changes with expert analysis of new procedure codes, revised guidelines, and high-impact updates affecting reimbursement, compliance, and inpatient coding accuracy.
This Memorial Day, we honor those who gave all for our freedom. Take 20% off sitewide through May 29 with code MEMORIAL26 at checkout
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
