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
Changes are effective Oct. 1, 2019. With fewer than 30 days remaining before the transition of payment for inpatient rehabilitation facility (IRF) services to the
The CMS Administrator could have chosen a better example to highlight plans for lower costs during recent remarks. With the release of the 2020 Inpatient
Changes are effective Oct. 1, 2019 In this article, we aim to continue to remind Inpatient Rehabilitation Facilities (IRFs) of the looming transition from utilizing
We have been reminding inpatient rehabilitation facilities (IRFs), repeatedly of late, and now we’re down to the final two months before the transition away from
There’s an updated version of the IRF-PAI manual. As we prepare for changes in how inpatient rehabilitation facilities (IRFs) are paid through the utilization of
IRFs can breathe easier; no change in policy. CMS has clarified the question of counting minutes of therapy provided by students. The Inpatient Rehabilitation Facility
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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