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
HHS issued a comprehensive fact sheet on what providers can expect. It’s a bit ironic that being mired in a federally declared Public Health Emergency
Defendant chains are accused of fudging their “usual and customary” rates for some drugs. Back in mid-January, the U.S. Supreme Court granted certiorari in two
A few weeks ago, the director of the federal Center for Medicaid and CHIP (Children’s Health Insurance Program) Services noted that “the return of Medicaid
As many as 15 million individuals may be disenrolled from Medicaid this year. The event is “The Medicaid Unwinding.” It starts on April 1. It
The state’s legislature recently passed Medicaid expansion. North Carolina has taken a commendable step forward in healthcare by expanding Medicaid to cover more low-income individuals.
Providers need to know their appeal rights and be prepared to exercise them. The other day I read an article about Medicare Advantage (MA) audits.
Proposal also seeks to increase information to patients. New proposals to improve the prior authorization process, while giving patients information on the status of prior
Claim denials for children 21 years of age or younger should be disputed through EPSDT. As you know, many states have expanded Medicaid. I am
Five years ago, the Centers for Medicare & Medicaid Services (CMS) first compiled a list of services that the newly implemented recovery audit contractor (RAC)
The fate of these hospitals looks grim. Rural hospitals have long been considered “on the edge.” They typically serve populations that are old, less affluent,
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
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
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