Plenty of Healthcare News to Cover as Summer Heats Up
There has been lots of healthcare news in the past two weeks. First, I hope all of you read my RACmonitor e-news article from July
There has been lots of healthcare news in the past two weeks. First, I hope all of you read my RACmonitor e-news article from July
Last week the New York Times published an article titled “The Moral Crisis of America’s Doctors” with a subheading stating, “the corporatization of healthcare has
Today, I’m writing about skilled nursing facilities (SNFs). The Centers for Medicare & Medicaid Services (CMS) recently directed the Medicare Administrative Contractors (MACs) to audit
Last week I wrote about the ongoing issue of Medicare Advantage (MA) denials related to appropriate transfer to a skilled nursing facility (SNF) and the
I took an unusual call from a colleague a few weeks ago. He was panicked, because his hospital has a physician who has been performing
Medicare Advantage (MA) companies continue to be a hot topic in the news, as their market penetration continues to increase despite ongoing concerns regarding denials
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
SNFs now have a golden opportunity to speak up about an issue that prevents many patients from accessing their care. We are now about a
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
On April 10, 2023, the Centers for Medicare & Medicaid Services (CMS) issued the fiscal year (FY) 2024 Medicare hospital inpatient prospective payment system (IPPS)
In considering the wording of contractual language, consider avoiding creating new problems for yourself. A clinic recently contacted us about an insurance contract featuring a
CMS releases final rule April 5. With an extremely compressed timeframe, the Centers for Medicare & Medicaid Services (CMS) released CMS-4201-F, the rule setting new
Michelle Wieczorek explores challenges, strategies, and best practices to AI implementation and ongoing monitoring in the middle revenue cycle through real-world use cases. She addresses critical issues such as the validation of AI algorithms, the importance of human validation in machine learning, and the delineation of responsibilities between buyers and vendors.
Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.
Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.
Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.
Join industry expert, Kathy Pride, RHIT, CPC, CPMA, CCS-P, for an in-depth exploration of Evaluation and Management (E/M) coding, tailored for healthcare professionals navigating recent guideline changes. Dive into advanced topics beyond mere code selection, including shared visits, criteria for selecting E/M levels, and documentation best practices. Gain clarity on complex guideline terminology and ensure compliance with regulatory standards. This comprehensive session is essential for coders, auditors, educators, and practitioners seeking to enhance their proficiency in E/M coding and maximize revenue capture.
This third session in the ICD10monitor 2025 IPPS Masterclass will feature a review of FY25 changes to the MS-DRG methodology and new technology add-on payments (NTAPs), presented by senior healthcare consultant Laurie Johnson, with bonus insights and analysis from CDI expert Dr. Erica Remer.
This second session in the ICD10monitor 2025 IPPS Masterclass will feature a review of the FY25 changes to ICD-10-PCS codes, presented by senior healthcare consultant Laurie Johnson, with bonus insights and analysis from CDI expert Dr. Erica Remer.
This first session in the ICD10monitor 2025 IPPS Masterclass will feature a review of FY25 changes to ICD-10-CM codes and guidelines, SDoH, CCs/MCCs and revisions to the MCE, presented by senior healthcare consultant Laurie Johnson, with bonus insights and analysis from Dr. Erica Remer.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY25 Inpatient Prospective Payment System (IPPS) Final Rule, including new ICD-10-CM/PCS codes, plus insights, analysis and answers to questions from the country’s most respected subject matter experts.
Dive deep into the world of Social Determinants of Health (SDoH) coding with our comprehensive webcast. Explore the latest OPPS codes for 2024, understand SDoH assessments, and discover effective strategies for integrating coding seamlessly into healthcare practices. Gain invaluable insights and practical knowledge to navigate the complexities of SDoH coding confidently. Join us to unlock the potential of coding in promoting holistic patient care.
HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2024 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.
Hospital staff continue to grapple with the complexities of Medicare notices. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, will present the latest requirements for preparation and delivery of CMS-mandated forms, including the Advance Beneficiary Notice (ABN), Hospital-Issued Notices of Noncoverage (HINNs), Important Message from Medicare (IMM) and Medicare Outpatient Observation Notice (MOON), and practical solutions through foolproof workflows and compliance auditing.
Unlock the keys to bridging the clinical-finance disconnect by transforming your approach to revenue cycle collaboration for superior patient care and financial prosperity!
Join Dr. Ronald Hirsch as he delves into the pivotal connection between case management, utilization review, and hospital revenue cycles, unveiling strategies to enhance communication and align goals effectively. Discover how to overcome hidden challenges hindering seamless collaboration and gain insights imperative for success
During this webcast Dr. Hirsch will breakdown the CMS-4201-F rule and the new federal regulations, how and when they will apply to Medicare Advantages plans.
Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’ is just $99 for a limited time! Use code WorldHealth24 at checkout.