Public Health Turmoil Creates Alternate Health Universe
It’s no secret to any of us that there has been quite a bit of recent disagreement between the opposing sides of the political aisle
It’s no secret to any of us that there has been quite a bit of recent disagreement between the opposing sides of the political aisle
I’m going to skip over the topic of the hour with the government shutdown and address two actions the federal government has taken in the
Those working in the risk adjustment arena realize that there are two common Risk Adjustment Data Validation (RADV) audits: one that tells Congress an error
As artificial intelligence (AI) becomes increasingly embedded in the U.S. healthcare system, the lack of comprehensive federal regulation has created something of a vacuum –
A recent ruling out of New York is the latest notable step in a very long-running saga involving alleged healthcare fraud by Omnicare, a Pharmacy
My association, 340B Health, represents hospitals that participate in the federal 340B drug pricing program. It has been an incredibly busy summer, with many new
The Trump administration has recently announced what it’s calling a “digital health ecosystem” that will allow for millions of Americans to upload personal health data
1. Payment & Reimbursement Changes For Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) site-neutral payments, the Centers for Medicare & Medicaid
The One Big Beautiful Bill Act, signed into law on July 4, 2025, includes sweeping changes to Medicaid including work requirements, cost-sharing, eligibility verification, and federal
A peachick has hatched! My daughter Madison loves the little peachick. He or she is thriving, and has imprinted on Madison. Follows her everywhere. Speaking
By now you have likely heard about Congress moving the “One Big Beautiful Bill” over the past few weeks to fulfill President Trump’s desire to
As a quick refresher, last year the U.S. Supreme Court overturned 40 years of precedent and upended statutory construction and enforcement by overturning the Chevron
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24