In medicine generally and psychiatry particularly, there has been increased attention in recent years to the social determinants of health (SDoH) and mental health, respectively.
EDITOR’S NOTE: Matt Bridge continues his three-part series on how to achieve a high-performing revenue cycle for your facility. Bridge reports that you need an
It is not a secret that physician payment from Medicare has been declining for years. In the past, physicians faced a yearly crisis in December,
Almost two months into the 2024 Outpatient Prospective Payment System (OPPS), I thought I would provide some clarity regarding the new social determinants of health
EDITOR’S NOTE: Matt Bridge begins a three-part series on how to achieve a high-performing revenue cycle for your facility. Bridge reports that you need an
Last week during Talk Ten Tuesdays, there were several questions about the Coordination and Maintenance Committee, as well as the CPT® Editorial Panel meetings. As
I would like to focus on clinical criteria today. It has been brought to my attention that some payers are citing the American Hospital Association
I am currently performing a fraud assessment, and since I can’t go back and educate the provider in question, I am going to share my
This report includes a collection of topics. Compliance, CPT® Panel Meeting, and new CPT codes for respiratory syncytial virus (RSV) vaccine administration are included in
In the 2023 Fourth Quarter of the American Hospital Association (AHA) Coding Clinic, there is discussion of two types of short-term external heart assist systems.
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
Back in September 2023, the Centers for Medicare & Medicaid Services (CMS) announced release of an MLN to better equip providers with documentation guidelines in
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.
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.
Master the FY 2027 ICD-10-CM changes, including new diagnosis codes, CC/MCC updates, and coding guideline revisions, with practical insights from nationally recognized coding and CDI experts.
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