Long-awaited and highly anticipated, providers hope other payers will follow suit. Healthcare insurer giant UnitedHealthcare (UHC) has announced that it will be suspending prior authorization
The saga of increased scrutiny of Medicare Advantage plans continues to unfold. UnitedHealthcare’s SuspensionCMS announced a suspension of one year for the UnitedHealthcare H5322 contract
Plan was “strongly opposed” by NY healthcare groups. The Healthcare Association of New York (HANY) told providers Tuesday that the Empire State that it will
The UHC sepsis definition raises new audit concerns. Each month, UnitedHealthcare (UHC) keeps providers appraised about its policy changes with an online bulletin. These bulletins
Expect denials as the healthcare giant is cracking down on Levels 4 and Level 5 UnitedHealthcare (UHC) will reportedly review and possibly adjust or deny
Proprietary algorithm to determine “correct” code and change claim. It’s clearly a new age in the coding of emergency department (ED) visits – after all,
More than three dozen advocacy groups appear to sway position of one of the nation’s leading carriers. In the June 2017 UnitedHealthcare (UHC) Bulletin, it
UHC bulletin excerpt underscores necessity of close scrutiny. In the June 2017 UnitedHealthcare (UHC) network bulletin, there was an article that addressed UHC’s decision to
UnitedHealthcare (UHC) is joining the ranks of those carriers that no longer cover consult codes (99241-99245 and 99251-99255), effective Oct. 1, 2017. This notification was
A former high-ranking official with a health insurance industry titan has filed a whistleblower lawsuit alleging that Medicare Advantage annually made tens of billions of
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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