In the last few weeks, I’ve taken several sheepish calls from folks indicating that they received a call from a government agent and proceeded to
The odds are high that there is someone in your organization who is seething at the perception that their boss is allowing, or even encouraging,
We all know that there is no law, regulation, or statute that medical records supporting payment by Medicare or Medicaid must be perfect. There is
The Biden Administration has found itself in court in the state of Texas again – but not over the No Surprises Act (NSA) this time!
Well, I’ve got a couple of updates for you in the absolute roller coaster that is the No Surprises Act’s Independent Dispute Resolution (IDR) process!
Let me start with a statement of the obvious and a brief overview of federal law. As for the obvious, if the U.S. Department of
The U.S. Department of Health and Human Services (HHS) has notably surpassed the targets established by a 2018 federal court ruling in its ongoing effort
If you totally unplugged this past weekend, you might just now be hearing about the fact that the House and Senate passed a stopgap funding
The Centers for Medicare & Medicaid Services (CMS) can’t seem to catch a break of late. 2023 has been a tough year for the agency,
How many of you know that Medicare Advantage (MA) plans is a synonym of Managed Care Organizations (MCOs)? I’m talking about an analogy between Medicare
In recent weeks, the Centers for Medicare & Medicaid Services (CMS) has been incredibly active in releasing a slew of updates that aim to extend
A client received a letter requesting a wide range of billing and coding information, and copies of variety of medical records before it concluded “please
Unlock the keys to bridging the clinical-finance disconnect by transforming your approach to revenue cycle collaboration for superior patient care and financial prosperity!
Join Dr. Ronald Hirsch as he delves into the pivotal connection between case management, utilization review, and hospital revenue cycles, unveiling strategies to enhance communication and align goals effectively. Discover how to overcome hidden challenges hindering seamless collaboration and gain insights imperative for success
During this webcast Dr. Hirsch will breakdown the CMS-4201-F rule and the new federal regulations, how and when they will apply to Medicare Advantages plans.
The CMS Two-Midnight Rule and short-stay audits are here to stay, impacting inpatient and outpatient admissions, ASC procedures, and Medicare Parts C & D. New for 2024, the Two-Midnight Rule applies to Medicare Advantage patients, requiring differentiation between Medicare plans affecting Case Managers, Utilization Review, and operational processes and knowledge of a vital distinction between these patients that influences post-discharge medical reviews and compliance risk. Join Michael G. Calahan for a comprehensive webcast covering federal laws for all admission processes. Gain the knowledge needed to navigate audits effectively and optimize patient access points, personnel, and compliance strategies. Learn Two-Midnight Rule essentials, Medicare Advantage implications, and compliance best practices. Discover operational insights for short-stay admissions, outpatient observation, and the ever-changing Inpatient-Only Listing.
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 2024 IPPS, OPPS and MPFS rules.
Uncover effective techniques to foster provider understanding of CDI, empower CDISs and coders to customize their queries for enhanced effectiveness, and learn to engage adult learners, leveraging their experiences for superior learning outcomes. Elevate your CDI expertise, leading to fewer coding errors, reduced claim denials, and minimized audit issues.
This exclusive ICD10monitor webcast series will help you acquire the critical knowledge you need to completely and accurately assign ICD-10-PCS and CPT® codes for spinal fusion and other common spinal procedures.
This exclusive ICD10monitor webcast is intended to elevate and streamline outpatient coding for spinal procedures. Our expert presenter, Kim Felix, RHIA, CCS., will provide clear, detailed explanations covering spinal anatomy, spinal procedures, and correct CPT coding practices.
During this exclusive ICD10monitor webcast, inpatient coders will gain a profound understanding of prevalent spinal procedures. They’ll delve into the intricate anatomy, grasp the purpose and method behind these procedures, uncover essential elements within physician documentation, and receive expert guidance, step by step, on constructing accurate ICD-10-PCS codes. It’s the key to enhancing their expertise and ensuring coding precision.
Explore comprehensive guidelines and best practices for secondary diagnosis coding in our illuminating webcast. Delve into the intricacies of accurately assigning secondary diagnosis codes to ensure precise medical documentation. Learn how to navigate complex scenarios and adhere to coding regulations while enhancing coding proficiency. Our expert-led webcast covers essential insights, including documentation requirements, sequencing strategies, and industry updates. Elevate your coding skills and stay current with the latest coding advancements so you can determine the correct DRG assignment to optimize reimbursement, support medical decision-making, and maintain compliance.
Enhance your inpatient coding precision and revenue with Principal Diagnosis Coding: Mastering Selection and Sequencing. Join our expert-led webcast to conquer the challenges of principal diagnosis selection and sequencing. We’ll decode the intricacies of ICD-10-CM guidelines, equipping you with a clear grasp of the rules and the official UHDDS principal diagnosis definition. Uncover the crucial role of coding conventions, master the sequencing of related conditions, and confidently tackle cases with equally valid principal diagnoses.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY24 Inpatient Prospective Payment System (IPPS) Final Rule, including new ICD-10-CM/PCS codes, plus insights, analysis and answers to questions from the country’s most respected subject matter experts.
This third session in our 2024 IPPS Summit will feature a review of FY24 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by senior healthcare consultant Laurie Johnson, with bonus insights and analysis from two acclaimed subject matter experts
Gain clarity on billing, patient notifications, and discharge appeal rights in social admissions. Join our webcast for essential insights and strategies to navigate this complex landscape, ensuring financial stability and optimal patient care.
Dr. Ronald Hirsch provides tried-and-true strategies and insight into outpatient in hospital bed stays including determining the applicable definition, who uses it, and when and how to bill for this circumstance, solidified with concrete case examples and expert insight.
Practical solutions for CDM departments to protect your hospital’s revenue.
This webcast teaches hospitals how to comply with CMS price transparency rules and compare their rates with peer hospitals. It covers creating a compliant machine-readable file, comparing negotiated rates, and improving pricing decisions.
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