MAs are taking advantage of excessive denials to reduce payments to providers. The U.S. Department of Health and Human Services (HHS) Office of Inspector General
The UHC sepsis definition raises new audit concerns. Each month, UnitedHealthcare (UHC) keeps providers appraised about its policy changes with an online bulletin. These bulletins
Federal officials said the health system received overpayments of at least $2.4 million from 2014 through 2016. The University of Wisconsin Hospitals and Clinics Authority
CMS offers advice through its Medicare Learning Network Connects bulletin to avoid coding errors. Mistakes happen, and errors do occur in the coding industry. The
Recoupment and one-day inpatient admission for total knee replacement. EDITOR’S NOTE: The following is a summary of a broadcast segment on Monitor Monday, May 7
OIG audits device credit reporting. The confluence of two major healthcare news stories is creating confusion among providers. News of changes to the national coverage
All audits are questionable, contends the author, so appeal all audit results. Providers ask me all the time – how will you legally prove that
OIG report shines spotlight on area of confusion for billing. In a recent report, the U.S. Department of Health and Human Services (HHS) Office of
The OIG has added specialty drug coverage and reimbursement by Medicaid to its Work Plan. In October, the OIG added specialty drug coverage and reimbursement
Tales abound regarding contractors’ errors negatively impacting providers. If you read my previous article on the audit by the U.S. Department of Health and Human
The resignation of HHS Secretary Tom Price, MD casts doubt on initiatives championed by the former orthopedic surgeon in altering the trajectory of the Patient
Once a year, for the past eight years, the U.S. Attorney General has announced his or her annual healthcare fraud enforcement efforts in the form
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.
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.
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.
This second session in our 2026 IPPS Masterclass will feature a review the FY26 changes to ICD-10-PCS codes. This information will be 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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