New Approach to Medicare Part D
In a significant overhaul of Medicare Part D, set to take effect in 2025, beneficiaries are poised to experience a transformative change in how prescription
In a significant overhaul of Medicare Part D, set to take effect in 2025, beneficiaries are poised to experience a transformative change in how prescription
Federal officials this week announced the rollout of a Final Rule for Medicare Part D prescription drug plans and the rapidly expanding Medicare Advantage (MA)
In the realm of healthcare, the ideal of transparency has long been a beacon of trust and accountability. However, the journey towards price transparency in
Centers for Medicare & Medicaid Services (CMS) enforcement of new price transparency rules began in January, and ClaraPrice, which provides consulting services to hospital IT,
The increasing and often unaffordable cost of prescription drugs in this country is a near-constant topic of discussion within the healthcare industry. The Biden Administration
In light of Medicare finally forcing big pharma to do what it has to do and negotiate drug prices, I want to talk about a
If you work for a hospital, please read this article closely. If you’re at any other type of healthcare entity, the price transparency rules don’t
As much as I love a state fair, it isn’t something I write about very often, because usually, the primary risk one would associate with
The Centers for Medicare & Medicaid Services (CMS) has announced a new approach to penalties applied under the Hospital Price Transparency rule. Before I describe
CMS is enforcing its rule with penalties. The Centers for Medicare & Medicaid Services (CMS) is focusing new funding and efforts on hospital price transparency
Benchmark rates for observation depend on understanding your numerator and denominator. First up, a shout-out goes to my friend Dr. Charles Locke in Maryland, an
Healthcare pricing is a complicated minefield. A recent RACmonitor article written by Govind Goyal described enforcement of the price transparency rule. At the Chicago-Kansas City
The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
Master the complexities of heart failure coding with this expert-led webcast by Emily Montemayor, CCS, CMBCS, COC, CPC, CPMA. Discover strategies to ensure compliance with ICD-10-CM guidelines, documentation integrity, and capture comorbidities like CKD and hypertension. Learn how to resolve coding challenges, improve documentation practices, and submit clean claims to minimize denials and safeguard your organization’s financial health. With practical insights and real-world examples, this session equips you to prevent revenue leakage, enhance compliance, and secure optimal reimbursement—all while supporting better patient outcomes.
Prepare your organization for the 2025 OPPS updates with expert insights from Tiffani Bouchard, CCS, CRCR, a Revenue Integrity Professional with over 30 years of experience. This webcast will address critical challenges in charge capture and coding, providing clarity on APC policies, C-APC packaging, exclusions, and payer-specific requirements. Attendees will learn actionable strategies to ensure compliance, optimize reimbursement, and mitigate risks of claim denials. Gain the knowledge needed to implement updates effectively, educate your team, and maintain seamless revenue cycle operations in the face of evolving OPPS complexities.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
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