I had an epiphany the other day while discussing compliant query composition with a very knowledgeable clinical documentation integrity specialist (CDIS). It will be easiest
Dr. Ronald Hirsch inspired this article – months ago, he asked me to look at a publication from Livanta and comment on it. Livanta is
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,
Today I want to write about one of our current hot-button topics: artificial intelligence, better known as AI. First, I want to pose the question:
Today I would like to share my opinion on proactive provider documentation decision-making technology. I am completely supportive of genuinely concurrent (that is, occurring in
Back in September 2023, the Centers for Medicare & Medicaid Services (CMS) announced release of an MLN to better equip providers with documentation guidelines in
Today I would like to call your attention to Type 2 myocardial infarction (MI), A21.A1, versus demand ischemia, I24.89. I frequently see denials associated with
I am the Co-Director of the Intensive Course in Medical Documentation: Clinical, Legal and Economic Implications for Healthcare Providers. It is a course created to
The new Healthcare Common Procedural Coding System (HCPCS) codes were released on Nov. 6. These codes include supplies, medications, implants, surgeries, etc. The latest release
Initially seen as a temporary solution in response to the pandemic, telehealth has proven its value and is clearly here to stay. But with this
Following my recent talks about Z-code capture and the value of reviewing case management documentation, I thought I would spend some time today focusing on
I have accepted that it is inevitable that artificial intelligence, or AI, is going to become an integral part of our healthcare process. The question
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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