Congress passed an appropriations bill to fund the U.S. Department of Health and Human Services (HHS) through the 2019 fiscal year. We may be rapidly
CDI can drive down adversarial determinations of medical necessity and costly denials. In my article published last week, titled Moving in the Right Direction in
A lesson in coding and policy. Medical marijuana, or cannabis, as it is commonly referred to in the healthcare field, is allowing chronically ill patients
Two recent studies report on the alarming rate of physician burnout. EDITOR’S NOTE: Physician burnout, a topic of great interest across the healthcare industry during recent years,
Ongoing ethical issues persist requiring leadership guidance daily We live and work in times that are very challenging, and ever-changing to say the least. We
The lesbian, gay, bisexual, transgender, and queer (or questioning) (LGBTQ) population faces barriers to appropriate healthcare access. EDITOR’S NOTE: The American Health Information Management Association
CMS proposes to ease burdens on providers. When it comes to the ever-changing Centers for Medicare & Medicaid Services (CMS) agency rules and regulations, one
Sharing insights on assumptive coding When I was a physician advisor, I used to offer a diabetic Charcot joint as an example of why we
With good collaboration and the right team members, continual improvements are attainable. Recently I have been engaged in a project of continual improvement in our
New ICD-10 codes that address human trafficking become effective Oct. 1. This year has seen the launch of the ICD-10 Z codes, and now we
The new definition includes clinical concepts that were not an option before when choosing an MI diagnosis. Since 2012, changes and updates have continued to
The clinical query process is a small yet important part of any CDI initiative. By now I am confident that most in the clinical documentation
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.
Artificial intelligence is rapidly transforming healthcare revenue cycle operations, from coding and auditing to compliance and denials. Join industry leaders Pam Warren (MaineHealth) and Raemarie Jimenez (AAPC) for a live fireside chat exploring how AI is changing workflows, workforce roles, payer-provider dynamics, and compliance risk—and what organizations should be doing now to prepare.
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.
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