The impact of ballot initiatives on healthcare seems to be growing. By Matthew Albright As of this past weekend, with Election Day still approaching, an
Key changes are pending in the areas of behavioral health, cancer screening, and dental – among others. The Centers for Medicare & Medicaid Services (CMS)
A recent survey has illustrated just how onerous the various federal regulations of healthcare have become. If you’re feeling extra productive and accomplished this morning
A close look at three extrapolation case histories. When the COVID-19 pandemic first hit in 2020, many folks assumed that it would not be an
A timely update on the NSA and the AEOB. In August, the administration published the final final rule on the No Surprises Act’s Independent Dispute
The Centers for Medicare & Medicaid Services are levying civil monetary fines for non-compliant hospitals. The feds are going after hospitals they believe are not
The newsletter reveals a startling revelation. Last week Kepro, the BFCC-QIO (Beneficiary and Family Centered Care Quality Improvement Organization), hereafter referred to as “QIO”) for
Double-dipping has been seen among some Managed Care Organizations. How many readers have undergone more than one audit? What about more than one audit for
Although the Biden Administration claims this is the final regulation, there is evidence more is yet to come. The Biden administration released the final No
The FAQ released recently yields information on the Independent Dispute Resolution. The FAQs related to the No Surprises Act final rule was released last week. Just
The Inflation Reduction Act and the No Surprises Act both impact seniors. Last week, both the House and the Senate passed the Inflation Reduction Act
Medicare beneficiaries are likely to reap some benefits from the new legislation. The Inflation Reduction Act is a topic that is different from what I
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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