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
CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention
The PFS proposal also includes a signature requirement. Last week, the Centers for Medicare & Medicaid Services (CMS) issued the proposed 2022 Physician Fee Schedule.
The reality is that silos are everywhere, and they are not necessarily bad, but need to be managed. There are silos in all aspects of
UnitedHealth says it will use proprietary software to deny claims. EDITOR’S NOTE: The topic of this article was previously covered by RACmonitor on separate occasions
OPPS rule could result in higher revenue. Whenever a rule changes, expect Recovery Audit Contractor (RAC) and/or targeted probe-and-educate (TPE) audits to hone in on
Direct verbal communication between referring and consulting physicians is the best practice. Communicating in the chart, while convenient and useful, rarely provides the most accurate
A complex process is simplified in a tabular comparison. Not infrequently, in the process of utilization review (UR), we run into situations in which, as
CMS E&M FAQ is likely to generate more questions than answers. Since the release by the Centers for Medicare & Medicaid Services (CMS) of the
The role has grown in both importance and stature. Back in 2012, Elizabeth Lamkin, MHA, now chief operating officer for the American College of Physician
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!
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!
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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