Highlights of the 2019 Medicare Physician Fee Schedule, released on Nov. 1, are provided by the author. There will be no change in E&M payment
“Outpatient” does not equate “same-day.” By this time last year, the Centers for Medicare & Medicaid Services (CMS) had notified providers that they were removing
Plaintiffs are the American Hospital Association and three other regional hospitals and healthcare systems. Providers with Medicare appeals pending may have their claims resolved sooner
CAR-T therapy could list a single service with a $1.4 million charge. I was honored to be able to speak at the annual meeting of
More than a third of ACOs might leave if the proposed rule takes effect. The comment period closed for the Centers for Medicare and Medicaid
The final rule on provider-based clinics is expected in early November. To understand changes being made relative to provider-based clinics, both Federal Registers must be
Chapter 8 changes appear to be less fair than ever before. “Life Isn’t Fair, but Government Must Be”— Former Texas Governor Ann Richards, 1991 Everyone
Many MAOs have overplayed the significance of this decision. On Sept. 7, in federal district court in Washington, D.C., in a case in which the
This is the definition of “incident to” for supervision requirements in hospitals. A recent RACmonitor article focused on the level of physician supervision required when
CMS removed the admission order as a condition of payment effective Oct. 1, 2018. The change in the 2019 Inpatient Prospective Payment System (IPPS) Final
New case law supports due process for Medicare providers. Due process is one of the cornerstones of our society. Due process is the universal guarantee
OMHA adds Chapter 14 to its case processing manual The Office of Medicare Hearings and Appeals (“OMHA”) has recently been updating its OMHA Case Processing
The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.
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.
Prepare your organization for the 2025 OPPS updates with expert insights from Tiffani Bouchard, CCS, CRCR, a Revenue Integrity Professional with over 30 years of experience. This webcast will address critical challenges in charge capture and coding, providing clarity on APC policies, C-APC packaging, exclusions, and payer-specific requirements. Attendees will learn actionable strategies to ensure compliance, optimize reimbursement, and mitigate risks of claim denials. Gain the knowledge needed to implement updates effectively, educate your team, and maintain seamless revenue cycle operations in the face of evolving OPPS complexities.
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.
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