Details will be announced during the Talk Ten Tuesdays broadcast today. By Chuck Buck The American Health Information Management Association (AHIMA) is releasing a new
In an unprecedented move, the Centers for Medicare & Medicaid Services (CMS) has proposed in the 2022 Outpatient Prospective Payment System (OPPS) Rule to put
The Centers for Disease Control and Prevention (CDC) published the ICD-10-CM Official Coding and Reporting Guidelines for the 2022 fiscal year (FY) on July 12.
As a former manager of clinical documentation integrity (CDI) and utilization review (UR) at an academic medical center, my focus was on understanding all possible
Now is the time when major healthcare rules are announced by the federal government. Some major regulations have been announced in the last few weeks.
The effective date for the FY 2022 Official Guidelines is Oct. 1, 2021 Released earlier in the year than in the past, the Official Guidelines
The defendant convicted in connection of one of the most massive fraud schemes in U.S. healthcare history is free after his sentence was commuted. I
Telehealth policies will lapse if something isn’t done quickly, as the PHE is scheduled to end on July 21. As lawmakers are lining up to
The proposed changes mark a direct effort to close health equity gaps. The Centers for Medicare & Medicaid Services (CMS) has proposed actions to close
Documentation is integral to solving this problem. UnitedHealthcare (UHC) recently threatened to implement a new policy wherein they would be retroactively denying some emergency department
Providers seeking to get ahead of the curve before the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Final Rule for
Comfort care is not an indication to stop documenting and coding. Last week, a listener reached out to me to ask me my opinion on
CMS CRUSH (Comprehensive Regulations to Uncover Suspicious Healthcare) signals a new era of data-driven program integrity oversight that extends far beyond coding and CDI. As federal scrutiny of claims, documentation, billing practices, provider enrollment, and payment accuracy intensifies, healthcare organizations must be prepared to identify and address vulnerabilities before they result in audits, denials, repayments, or enforcement actions. Join us for this timely webcast to learn what CMS CRUSH could mean for your organization and discover practical strategies to strengthen documentation, claims integrity, compliance readiness, and reimbursement defensibility.
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.
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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