A landmark Supreme Court decision is a game-changer in this area. After my last segment on Monitor Mondays, several colleagues contacted me about a comment
The program aims to lower drug costs and improve affordability for Americans with Medicare. The Centers for Medicare & Medicaid Services (CMS) has released initial
HCC scores also don’t predict costs (or payments). EDITOR’S NOTE: This is the second and final article in a two-part series about Hierarchical Condition Category
A highly publicized UHC denial of care led to more questions than answers. By now many have read the ProPublica expose on how UnitedHealthcare (UHC)
It’s sometimes better, sometimes worse for the provider. The Medicare Program Integrity Manual (PIM) over the years has undergone a number of changes. Here, we
Supporting her staff is first and foremost for Ally Phillipsen at Genesis HealthCare. EDITOR’S NOTE: RACmonitor, in association with RevKeep, is producing a three-part series
A major Southern hospital system is confronting the challenge of post-payment audits. EDITOR’S NOTE: RACmonitor, in association with RevKeep, is producing a three-part series on
Healthcare entrepreneur Kevin Lasser understands the nuances of the post-payment audit problem – and hopes for a solution. EDITOR’S NOTE: RACmonitor, in association with RevKeep,
Always challenge the extrapolation. It is my opinion that extrapolation is used too loosely in healthcare audits. What I mean is that sample sizes are
Two key insurers were recently targeted for HHS OIG scrutiny. I was all set to dive into the September audits of HumanaChoice and BlueCross Blue
There are 50 Shades of Grey in federal prepayment review. I hate wishy-washy laws. If a law exists, in my mind, it should be specific.
The good, the bad and the ugly in healthcare news reporting. It is time for another multi-topic update. Some weeks produce just too much news
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.
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!
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.
This first session in our 2026 IPPS Masterclass will feature an in-depth explanation of FY26 changes to ICD-10-CM codes and guidelines, CCs/MCCs, and revisions to the MCE, presented by 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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