Healthcare workers facing increased threats of violence. The past few years have been difficult for health care workers, particularly in hospitals. Waves of the pandemic,
Medicare providers are your claims clean? Federal regulations mandate that 90 percent of “clean claims” must be paid to healthcare providers within 30 days. But
The case, which arose on April 1, demonstrates an exhaustion of administrative remedies. In Guidry v. CMS, Guidry was a pro se medical doctor. This
Different states have different rules for pursuing arbitration. The federal arbitration portal for the No Surprises Act (NSA) is now open for business. The portal
The plan includes a goal to improve maternal health outcomes. Federal officials currently engaged in a prolonged push to address health disparities across the U.S.
Impact on SNFs was foreseen in the IPPS proposed rule. Last week, the Centers for Medicare & Medicaid Services (CMS) followed up on President Biden’s
The federal government has now launched the independent dispute resolution process. The Biden Administration has extended the COVID-19 public health emergency (PHE) for another 90
The case of convicted former nurse RaDonda Vaught has created a cascade of opinions but are the experts right? Let’s consider a scenario: A 30-year-old
COVID-19 relief bill sinks as CMS expects to open NSA arbitration portal. Congress failed to pass a $10 billion COVID relief package last week before
Sticker shock no more. Today I will be giving you my point of view on the No Surprises Act – a topic of great interest
After nearly two decades, passage of a National Provider Identifier remains elusive. Since the Health Insurance Portability and Accountability Act (HIPAA) was passed and signed
A recent whistleblower case decision has revealed how federal prosecutors going after providers for fraud have been frustrated by the murkiness of federal regulations. United
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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