Providers should never C&P material they have not read nor vetted for accuracy. A young Jeopardy! champion died from bilateral pulmonary emboli following a colectomy
Problem lists are a problem because often they are not updated. Over the last year, we have heard much about Medicare Advantage (MA) health plans
Efficiencies increase health system revenues. Major shifts in the healthcare landscape over the last 10 years have substantially impacted hospital system reimbursement. Placing an ever-greater
What can medical assistants (MAs) do and not do? Medical assistants (MAs) have a narrow list of things they can do for patients or a
Documentation is integral to solving this problem. UnitedHealthcare (UHC) recently threatened to implement a new policy wherein they would be retroactively denying some emergency department
Comfort care is not an indication to stop documenting and coding. Last week, a listener reached out to me to ask me my opinion on
Documentation by association. My home office is located in Merritt Island, Florida, and if you’re not familiar with where that is, you’re not the first.
EDITOR’S NOTE: This article was originally published online last week, but following review by members of the editorial board to correct minor factual errors, it has
Late physician signatures pose serious issues. In the last few months, I have had questions about late signatures on documentation come in from several clients.
All bad documentation is based on lies – the lies doctors (and all human beings) tell themselves. We always believe our lies, because they are
Understanding why a culture of compliance in coding and documentation is so important. Compliance is a large part of our duties in healthcare. It is
As the provision of healthcare changes, so too must clinical documentation improvement. I have always been convinced of the strong capabilities of current clinical documentation
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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.
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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.
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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.
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