During the last several months, the federal government has been siding with healthcare providers in an all-out assault on the prior authorization process, which requires
Physician advisors can serve as a trusted resource for any EMTALA concerns.
The Association has filed a lawsuit against the federal No Surprises Act. The Texas Medical Association (TMA) is challenging a 600-percent hike in administrative fees
Providers should take a close look at what traditionally accepted forms of care are, in fact, unnecessary. Let’s start today with a silly denial. Now,
CMS will delay until next year a final decision on this contentious issue. Every year, around this time, I feel a bit like Steve Martin
Key changes are pending in the areas of behavioral health, cancer screening, and dental – among others. The Centers for Medicare & Medicaid Services (CMS)
CMS used secret shoppers to call phone numbers advertised on television and discovered a lot of incorrect information and attempts by the agents to coerce
My Marine Corps father used to tell me that early was on time, on time was late and late was unacceptable. Time is truly a
CMS is discontinuing certificates for medical necessity and durable medical equipment. CMS is discontinuing Certificates of Medical Necessity and Durable Medical Equipment (DME) information forms
A recent headline, and an older book, offer cautionary tales. The NBC News headline, “Florida hospital ignored years of complaints about surgeon, patients and families
The value added by physician advisors was recognized as both regulatory and financial. Recently, I was prompted to recall how many years I have worked
To be a full-time physician advisor, an individual must give up their regular clinical medical practice. When I became a physician advisor at Sherman Hospital
Familiarize yourself with the dramatic 2023 changes to codes, coding guidelines and documentation requirements for evaluation and management (E&M) split/shared and incident-to services.
Dr. Ronald Hirsch breaks down significant 2023 changes to coding and billing requirements for hospital observation services, including new physician E&M coding rules.
Learn how to save your facility hundreds of thousands of dollars in repayments and fines by correctly following CMS requirements for implantable medical device credit reporting. We provide you with all the need-to-know protocols, along with the steps for correct compliance while offering best practices to implement a viable strategy in your facility.
During an exclusive RACmonitor webcast, healthcare attorney Knicole Emanuel will explain in simple, easy-to-understand language the peril of the coming overpayment audits and describe your legal defenses.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2023 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Get access to important guidance on each of the AHA‘s 2023 ICD-10-CM/PCS Quarterly Coding Clinics with information-packed on-demand webcasts available shortly after each official publication.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s third quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Kay Piper reviews the guidance and updates coders on information in the AHA’s second quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s first quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Why should you be focused on SDOH data and ICD-10-CM Z codes? How can you integrate the capture of these elements into your workflows? Get guidance now — before new CMS assessment and reporting mandates take effect.
Set yourself up for appeal success with knowledge about the legitimate presentations of acute heart failure, the common vulnerabilities that auditors identify, the challenges clinical teams face, and how to write a concise and compliant validation query.
Gain a clear understanding of the documentation issues that can sabotage reimbursement for payment hierarchical condition categories (HCCs) and how you can mitigate your risks with a strong CDI program.
What are the changes to the IPO and ACS lists for 2023? What auditor trends do you need to watch out for in the new year? Don’t be caught off guard. Register today for this essential regulatory update led by Dr. Ronald Hirsch.
Take away tried-and-true strategies for ensuring that your Utilization Review committee is working effectively
A massive task lies ahead! Now’s the time to start preparing your case management and utilization review teams for successful implementation of changes contained in the 2023 IPPS, OPPS and MPFS rules.
Learn how to achieve complete, accurate documentation that establishes medical necessity and how to differentiate between billable and non-billable services.
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