Some flareups may lead to readmissions within 30 days. We can all agree that we want to fully treat our patients’ acute problems that require
The prepayment review is the equivalency of the American legal tradition that holds “you’re guilty until proven innocent.” It’s hard enough to be one
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
Survey data suggests that hospital executives, physician advisors, and case managers are not always on the same page. Sound Physicians‘ recent nationwide survey provides insights
The proposed increase is approximately 2.8 percent. Hear ye, hear ye: there will be a Medicare reimbursement rate increase! On April 27, the Centers for
BPCI models require a working relationship between inpatient and outpatient settings. The federal Bundled Payments for Care Improvement (BPCI) initiative links reimbursement of services rendered
Program integrity at the Centers for Medicare & Medicaid Services (CMS) is under pressure to properly conduct Recovery Audit Contractor (RAC) and Medicare Administrative Contractor
HRSA is not a HIPAA-covered entity, so the official coding rules do not need to be followed when submitting claims. EDITOR’S NOTE: On this week’s
Back billing is key to remaining in business during COVID-19. One of the questions that I have heard repeatedly during the continuing COVID-19 pandemic was
Reimbursement for such services has grown during recent weeks. Many healthcare entities are facing tough economic times. There is a possible solution that benefits patients
The Chicago-area producers of the coveted new testing kits plan to generate 20 million units per month by June. EDITOR’S NOTE: During recent weeks, the
At issue: hospital overpayments of $54.4 million. There has been recent talk on an online user group that many hospitals have had recoupments of payment
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!
Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals. Don’t miss this chance to protect your hospital’s revenue and reputation!
Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!
Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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