As a wary nation emerges from lockdown, front-line healthcare workers know that an uncertain future remains ahead.
One of the most stressful things about the COVID-19 pandemic is how fast things are changing. Emergency medicine has always been a stressful career, and the nature of the work, combined with the weekend/night/holiday shifts, have created significant strain on my life and relationships over the years. It is also a job that puts you at risk for assault, injury, or even death. Over the years, I have had my life threatened by those distressed over an unexpected outcome, or the addicted, over an opioid prescription. During the 2009 swine flu pandemic, I thought I might die when I contracted it and had to see patients anyway due to short staffing, but I didn’t. To work in the ED during this pandemic, you accept that you are taking a real (albeit small) chance with your life. But I can’t recall seeing any other time in my career when things changed so fast.
Overall, my region has fared better than other regions of the country, and my native West Virginia is moving towards relaxing social distancing measures aligned with the data model from the University of Washington. In my clinical practice, I am seeing fewer COVID/suspected COVID patients than in previous weeks. I always focus on the suspected patients, because that is all you can say about them when they first come through your door. Testing has changed from a 5-7-day turnaround to a 24-hour turnaround where I have been working, and that has lifted the burden on how long you have to isolate someone in the hospital or quarantine them at home. In the first weeks of the pandemic, we thought that 90 percent of COVID-19 patients would have a fever, and to preserve PPE, I would save my solitary N-95 mask for febrile patients. Based on the Journal of the American Medical Association (JAMA) study from Northwell last week, only 30 percent of these patients present with fever. So I have changed my approach again, donning full PPE, all day, every day until it falls apart, and then I get a new mask from a secret stash that a colleague told me about. We are continuing to see true emergency cases and slightly higher volumes of behavioral health patients who are decompensating from our collective anxiety. In yet another change, we are starting to see more less-acute cases, as patients are either responding to messaging about lifting restrictions or are suffering from over a month without primary care. I have seen a couple of cases that became surgical emergencies directly related to the delay of their elective cases.
I think we will continue to see things shift as we start to open things back up. We will see cases rise and fall in certain areas, and I am sure some states will go back to social distancing. Given the low association with fever, the number of asymptomatic carriers, and the estimated 10-fold more than those tested who are infected among us, I think that we will wax and wane with this for the next year. But to be clear, social distancing has worked. It has bought us time: time to learn about the disease, time to learn about what treatments work, and time to work on a vaccine. It has also given me time to see that, from a fatality rate, this first wave is going to be about three times as bad as the annual flu season. That is, until something else changes.
I receive a lot of newsletters every morning to help me stay abreast of what is happening in the healthcare industry. A troubling recent trend
EDITOR’S NOTE Day 3 of the federal shutdown continues. This article by Mark Spivey is part of a special section today published by RACmonitor and
Please log in to your account to comment on this article.
Expert presenters Kathy Pride, RHIT, CPC, CCS-P, CPMA, and Brandi Russell, RHIA, CCS, COC, CPMA, break down complex fracture care coding rules, walk through correct modifier application (-25, -57, 54, 55), and clarify sequencing for initial and subsequent encounters. Attendees will gain the practical knowledge needed to submit clean claims, ensure compliance, and stay one step ahead of payer audits in 2026.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Stay ahead of the 2026-2027 audit surge with “Top 10 Audit Targets for 2026-2027 for Hospitals & Physicians: Protect Your Revenue,” a high-impact webcast led by Michael Calahan, PA, MBA. This concise session gives hospitals and physicians clear insight into the most likely federal audit targets, such as E/M services, split/shared and critical care, observation and admissions, device credits, and Two-Midnight Rule changes, and shows how to tighten documentation, coding, and internal processes to reduce denials, recoupments, and penalties. Attendees walk away with practical best practices to protect revenue, strengthen compliance, and better prepare their teams for inevitable audits.
As AI reshapes healthcare compliance, the risk of biased outputs and opaque decision-making grows. This webcast, led by Frank Cohen, delivers a practical Four-Pillar Governance Framework—Transparency, Accountability, Fairness, and Explainability—to help you govern AI-driven claim auditing with confidence. Learn how to identify and mitigate bias, implement robust human oversight, and document defensible AI review processes that regulators and auditors will accept. Discover concrete remedies, from rotation protocols to uncertainty scoring, and actionable steps to evaluate vendors before contracts are signed. In a regulatory landscape that moves faster than ever, gain the tools to stay compliant, defend your processes, and reduce liability while maintaining operational effectiveness.
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 1 with code CYBER25
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
