This question can help you evaluate lawyers EDITOR’S NOTE: This is the second and final installment in a two-part series as to when facilities should
Is CMS preparing to slash payments for procedures with 10- and 90-day global periods? While thousands of doctors have submitted mostly unfavorable comments to the
Not enough information in the public use databases to know that a claim is fraudulent. “In God we trust; all others bring data.” That is
If approved, reviews would impact RAC Regions 1 through 4 in all states. In November 2017, the Centers for Medicare & Medicaid Services (CMS) announced
I have whined in a previous RACmonitor enews article about how the importance given to the admission order in today’s healthcare industry makes absolutely no
Error reported by WPS/GHA might have nationwide ramifications. Medicare Administrative Contractor (MAC) WPS GHA today confirmed that an enhancement to its Fiscal Intermediary Shared System
CMS engages in lively discussion about the proposed 2019 MPFS. The Centers for Medicare & Medicaid Services (CMS) was asked yesterday by a listener if the agency
2019 E&M changes will impact all areas of practice management. Far-reaching impacts to work relative value unit (RVU)-based compensation models that will pay providers in
The proposal would present a dangerous precedent for all of medicine. On July 12, 2018, the Centers for Medicare & Medicaid Services (CMS) released its
Condition 44 is one of three perplexing issues reviewed by the author. Last week was a boring regulatory week, other than the continuing talk about
Practices need to get a handle on both their financial and RVU impacts. Recently, the Centers for Medicare & Medicaid Services (CMS) released a proposed
The proposal is on the table as part of proposed E&M changes. By now I am sure that everyone is well aware that the Centers
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
This third session in our 2026 IPPS Masterclass will feature a review of FY26 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by nationally recognized ICD-10 coding expert Christine Geiger, MA, RHIA, CCS, CRC, with bonus insights and analysis from Dr. James Kennedy.
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