IFR providers expect that the pandemic as well as new regulatory issues will impact their services. 2020 was certainly a historical year, punctuated by the
The CMS proposal to eliminate the Inpatient-Only List, does not mean that all procedures are to be performed as outpatient. On Jan. 18, 2018, RACmonitor
The list will be eliminated over the course of three years. Federal officials unveiled the 2021 Outpatient Prospective Payment System (OPPS) Final Rule this week,
With an expected ramp-up in audits and denials for care across all healthcare services in the coming months, we continue to hear questions related to
Centers for Medicare & Medicaid Services are proposing to eliminate the inpatient-only list over the next three years. Medicare’s often-misunderstood inpatient-only list may soon be
The Coronavirus Aid, Relief, and Economic Security (CARES) Act signed into law on March 27 included provisions that would waive the requirement that a Medicare
Health systems are grappling with custodial/social admissions from the ED. A specific quandary is playing out in emergency departments (EDs) all over the country, and
At issue: hospital overpayments of $54.4 million. There has been recent talk on an online user group that many hospitals have had recoupments of payment
The audit environment is unlikely to improve. On Monday, Jan. 14, the Monitor Mondays panel of experts came together to celebrate the 10th anniversary of
CMS is expected to release instructions and sub-regulatory guidance in 2020. It was way back in 2015 when the Centers for Medicare & Medicaid Services
Compliance is mandatory, but data from CMS remains unavailable at this time. The discharge planning day of reckoning is today, Black Friday, Nov. 29, 2019
Direct verbal communication between referring and consulting physicians is the best practice. Communicating in the chart, while convenient and useful, rarely provides the most accurate
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
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.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
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.
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
