Clinical trials for the medication showed no significant improvement in patients. Last week was a big week for those afflicted with Alzheimer’s disease, as the
This is what providers can expect in 2022 in the form of new technology audits. During 2022, healthcare providers will see more options to exploit
Changes to the MPFS, OPPS, and HHPPS were announced on the same day. Rather than a “news dump” late on a Friday afternoon, federal healthcare
Summary highlights from the ACPA’s NPAC 2021 conference: “Advising in an Unconventional World.” The Centers for Medicare & Medicaid Services (CMS) continues to create confusion
There is an acute exacerbation of angry patients occurring at this time. EDITOR’S NOTE: RACmonitor will be producing an occasional series on this problem in
The Medicare Advantage market is an oligopoly. The Medicare Advantage (MA) market is an oligopoly, with limited competition. In 2020, the program costs were $314
The DOJ Sept. 13 filing of a complaint in intervention in a case against Buffalo-based Independent Health (IH) and its coding consultant subsidiary, DxID is
Understanding the intersection of COVID-19 and SDoH. Over the past 20 months, I’ve reviewed countless nooks and crannies of COVID’s intersection with the social determinants
Your health system should define your own standard for infrequency. EDITOR’S NOTE: For valuable context to this article, the author suggests the Dr. Juliet Ugarte
The announcement will free up federal resources to aid flood- and wind-torn communities. EDITOR’S NOTE: Article author Mark Spivey is a native and current resident
Rescue efforts continue with little hope in sight for relief. Less than 41 percent of all the people in Louisiana are currently vaccinated against COVID-19.
While utilization of upper-level visit codes will continue to increase, risk will likely remain stable., There has been so much in the way of education,
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.
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