CDI people, processes, and technologies must adapt to changes if a facility’s outcomes are not to be unintentionally misrepresented. The Centers for Medicare & Medicaid
HACRP is designed to reduce rates of healthcare-associated infections Most clinical documentation improvement (CDI) professionals are aware of hospital-acquired conditions (HACs). In fact, reviewing a
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
A reader says that coders, not CDISs, are querying physicians. Across the archipelago of the Internet came a timid yelp to be heard one recent
To query or not query that is the question. Querying is the lifeline of clinical documentation integrity (CDI) professionals and many coding professionals. In fact,
We often overlook the human component of metrics within our profession. I recently received some feedback on an article I wrote about the metrics used
The three-part series is in response to listeners’ requests. The long-running live Internet broadcast Talk TenTuesdays will debut a three-part series on coding and documentation
There are certain key elements of consideration during CDI review of COVID-19 patients. Understanding how to clinically validate sepsis and differentiate between sepsis and septicemia
Typical CDI programs are intended to drive reimbursement through diagnosis securement, contributing to improved case mix index. The COVID-19 pandemic is placing monumental financial stressors
The CDI approach to PSIs should be to scrutinize the indicators for the inclusion and exclusion criteria. I believe that patient safety indicators (PSIs) serve
Compliance is a big part of the risk adjustment HCC. Everyone is welcoming the New Year, and I am among them. This is a good
The principles focus on continuous improvement. There have been numerous articles and other materials written promoting the material benefits of implementing some if not all
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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