I had the pleasure of attending the annual California Health Information Conference in Long Beach, California, as an attendee and as a speaker, last week.
In a significant policy shift with wide-ranging implications for healthcare operations, the Centers for Medicare & Medicaid Services (CMS) announced that it will ramp up
Former President Joe Biden’s recent diagnosis of stage 4 metastatic prostate cancer, marked by a Gleason score of 9, has raised questions about how such
I recently attended an industry conference. I must say it was one of the best conferences I’ve attended in a long time. There was great
Radiology reports are rich with clinical detail—abnormalities, precise anatomy, and incidental findings—but that level of detail doesn’t always translate cleanly into ICD-10 coding. In my
Clinical documentation integrity (CDI) has matured beyond its initial focus on coding accuracy and Diagnosis-Related Group (DRG) optimization. In 2025, it is central to payer
Custodial or social hospitalizations have been a long-standing issue within acute care hospitals. These patients generally arrive to the Emergency Department (ED) with vague or
MedLearn Media is launching an online resource believed to be useful for professional coders, charge capture, compliance, and revenue integrity specialists alike. DrugCode Pro is
As the healthcare industry changes, there needs to be a shift from a growth perspective to an efficiency perspective. Most hospitals had their highest case
In a follow-up to last week’s article about when discharge lounges do not work, I thought I would elaborate today on when the concept can
Effective communication is critical in navigating clinical and non-clinical interactions, addressing generational and gender-specific differences, and fostering collaboration. By understanding how poor communication can affect
I recently came across a denial indicating that a query was noncompliant because it did not include evidence why the query was needed. I was
Medicare regulations are complex and even seasoned professionals struggle to apply them consistently. Due to overwhelming demand, Dr. Hirsch returns for Part 2 of Ask Dr. Hirsch: Clarifying Medicare’s Most Misunderstood Rules to answer even more of Medicare’s most misunderstood questions, covering inpatient status, observation, SNF access, Medicare Advantage denials, and more. Join Dr. Hirsch as he provides clear, referenced answers to real-world questions submitted by your peers, helping you navigate Medicare compliance with confidence and clarity.
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
Stay ahead of FY 2027 reimbursement changes with expert analysis of MS-DRG shifts, NTAP updates, Medicare Code Edits, and emerging technologies impacting inpatient payment accuracy.
Stay ahead of FY 2027 ICD-10-PCS changes with expert analysis of new procedure codes, revised guidelines, and high-impact updates affecting reimbursement, compliance, and inpatient coding accuracy.
Master the FY 2027 ICD-10-CM changes, including new diagnosis codes, CC/MCC updates, and coding guideline revisions, with practical insights from nationally recognized coding and CDI experts.
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