Insurers Aren’t Always the Bad Guy – Even if They Often Are
Some of you may have read my article from last week kindly published as a special bulletin. For those who did not, let me recap.
Some of you may have read my article from last week kindly published as a special bulletin. For those who did not, let me recap.
In a move that has garnered significant attention, last week President Trump issued an executive order that rescinded a series of previously issued executive orders
News reports have revealed that the ammunition used in the fatal shooting earlier this week of Brian Thompson, Chief Executive Officer (CEO) for UnitedHealthcare (UHC),
Nearly 20 hours after an assailant fatally shot Brian Thompson, chief executive officer for UnitedHealthcare (UHC), the manhunt continues for what witnesses described as a
While it is common to have payer contracts include a substantial percentage discount off of your billed charge, the practice creates avoidable risk. Healthcare pricing
Four months after a significant cyberattack forced its systems offline, a UnitedHealth subsidiary, Change Healthcare, has disclosed a major data breach. In a recent notification,
It looked like a cluster of small translucent golf balls stuck to one another. Nothing was moving. Could that be what causes so much trouble?
If one judges by statistics and performance scorecards alone, in the United States, healthcare means high cost and low quality. The expenditures are enormous. Healthcare
Unsurprisingly, I am writing about the No Surprises Act (NSA) today. Last year, I had quite an unwelcome surprise. I was thrown from my horse
The move comes as an estimated 10,000 baby boomers retire every day. It may come as a shock to realize that the nation’s oldest baby
On March 18, 2020, The Families First Coronavirus Response Act mandated continuous coverage for Medicaid enrollees during the public health emergency. Over the next three
Lately, I have been inundated with Medicare and Medicaid healthcare providers getting audited for evaluation and management (E&M) codes. I know Dr. Hirsch (Ronald Hirsch,
Stay ahead of Medicare Advantage’s 2025-2026 regulatory changes in this critical webcast featuring expert Tiffany Ferguson, LMSW, CMAC, ACM. Learn how new CMS rules limit MA plan denials, protect hospitals from retroactive claim reopenings, and modify Two-Midnight Rule enforcement—plus key insights on omitted SDoH mandates and heightened readmission scrutiny. Discover actionable strategies to safeguard revenue, ensure compliance, and adapt to evolving health equity priorities before the June 2025 deadline. Essential for hospitals, revenue cycle teams, and compliance professionals navigating MA’s shifting landscape.
Struggling with CMS’s 3-Day Payment Window? Join compliance expert Michael G. Calahan, PA, MBA, CCO, to master billing restrictions for pre-admission and inter-facility services. Learn how to avoid audit risks, optimize revenue cycle workflows, and ensure compliance across departments. Critical for C-suite leaders, providers, coders, revenue cycle teams, and compliance teams—this webcast delivers actionable strategies to protect reimbursements and meet federal regulations.
Providers face increasing Medicare audits when using skin substitute grafts, leaving many unprepared for claim denials and financial liabilities. Join veteran healthcare attorney Andrew B. Wachler, Esq., in this essential webcast and master the Medicare audit process, learn best practices for compliant billing and documentation, and mitigate fraud and abuse risks. With actionable insights and a live Q&A session, you’ll gain the tools to defend your practice and ensure compliance in this rapidly evolving landscape.
Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.
Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals. Don’t miss this chance to protect your hospital’s revenue and reputation!
Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!
Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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