The U.S. Office of Minority Health (OMH) released last Tuesday new public files on Socio-demographic and Health Characteristics of Medicare Beneficiaries Living in the Community
The Biden Administration has announced that it is poised to begin collecting feedback regarding proposed sweeping changes to the growing Medicare Advantage (MA) marketplace, marking
A new code, recently announced by the Centers for Medicare & Medicaid Services (CMS), is effective now and according to some it’s expected to keep
If you came across my recent report on the significant concern of “maternity deserts” in the U.S., as you will recall, the widely accepted definition
Back in September 2023, the Centers for Medicare & Medicaid Services (CMS) announced release of an MLN to better equip providers with documentation guidelines in
The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) released a report on a Medicare Advantage Compliance Audit of SelectCare
EDITOR’S NOTE: This story was first reported by Mr. Frank Cohen during the live Monitor Monday broadcast, Monday, Jan. 8, 2024. In 2021, the Centers
Happy 2024! This article will focus on a couple of news highlights that emerged over the holiday break. First, the LOINC and Health Data Standards
The Centers for Medicare & Medicaid Services (CMS) has released 41 new procedure codes, which are effective April 1, 2024. The new codes were posted
Cyberattacks and ransomware have been an ongoing story throughout the entire year, with hospitals and healthcare systems being one of the most popular targets for
It has been about six months since I last reported on the growing concern of maternal care, and in particular, the known issues of maternal
Recent changes to the minimum data set (MDS) assessment and recent audit activity targeting skilled nursing facilities (SNFs) appear to be an emerging issue. As
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.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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