What should you do if you get an email with the subject line “U.S. Office of Inspector General HHS – Special Investigations?” A doctor I’m
Let me start with a wild Medicare Advantage (MA) denial of inpatient admission. This was a 75-year-old male who fell. The patent had chronic atrial
EDITOR’S NOTE: Following last Monday’s Monitor Monday Internet broadcast, the U.S. Department of Health & Human Services (HHS) posted new guidance and an online portal,
The Office of Inspector General (OIG) of the U.S. Department of Health and Human Services (HHS) recently released a concerning audit report revealing widespread compliance
EDITOR’S NOTE: Senior healthcare consultant Cheryl Ericson reported this story live today during Monitor Mondays. Ericson is the director of clinical documentation integrity (CDI) and
When they came for the watchdogs, they did so in the middle of the night. As many as 18 Inspectors General of various federal agencies,
Well, if ever there was a time of great uncertainty in healthcare, it is right now. The new administration will bring new leadership with new
While President-elect Trump’s pick for U.S. Department of Health and Human Services (HHS) Secretary, Robert F. Kennedy, Jr., put the agency in even international newspapers
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) has posted a report titled Additional Oversight of Remote Patient Monitoring
I was fortunate to obtain excerpts from an appeal letter submitted by a hospital in response to a Medicare Advantage (MA) denial from Humana. The
While many of you are used to me aiming my wrath at payers, today I have a different target: the U.S. Department of Health and
Last week I discussed the new-to-me terminology of “the patient-directed discharge.” Well, this week my new term is “administrative harm,” which was highlighted in an
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
Fraud convictions don’t just punish a few bad claims; they can wipe out years of reimbursements. Don’t wait for an audit to learn the rules. Join Frank Cohen, MPA, for a live Q&A on spotting red flags, avoiding liability, and protecting your practice. Register now and bring your questions!
Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025. Register today and be a part of the conversation!
Vaccine policies, billing rules, and compliance risks are changing fast! How will your organization adapt? Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating new Medicare mandates, coding updates, and legal challenges in vaccination programs. Get expert answers on billing, compliance, outbreak risks, and operational strategies to protect your facility and patients. . Join us live and bring your questions to the table.
Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals. Don’t miss this chance to protect your hospital’s revenue and reputation!
Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!
Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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