I am Just a Bill
Timothy Powell, CPA, CHCP
November 5, 2024
Today is election day. I wanted to talk about the process by which laws are passed and regulations created in healthcare. Recently, the fall of
Today is election day. I wanted to talk about the process by which laws are passed and regulations created in healthcare. Recently, the fall of
The Age-Friendly Hospital Rating is a new structural measure included in the Centers for Medicare & Medicaid Services (CMS) 2025 Inpatient Prospective Payment System (IPPS)
The Centers for Medicare & Medicaid Services (CMS) has released the Inpatient Prospective Payment System (IPPS) Final Rule for the 2025 fiscal year (FY). Highly
In December 2022, I reported on a proposed rule from the Centers for Medicare & Medicaid Services (CMS) about updating requirements for prior authorization (PA),
Hierarchical Condition Categories (HCCs) and value-based care have been a major focus for healthcare organizations during recent years. As many of you may know, the
This is the season for reporting proposed and final payment rules for FY 2024. After a brief pause during the winter months, the Centers for
Final rule is intended to hold health insurance companies to higher standards. The final rule issued recently by the U.S. Department of Health and Human
The final rules become effective Jan. 1, 2023. Amid this election season, the Centers for Medicare & Medicaid Services (CMS) has published final rules for
Some SDoH conditions are more likely than other to be impactful on healthcare consumption. The Centers for Medicare & Medicaid Services (CMS) unveiled the fiscal
EDITOR’S NOTE: CMS has published the Fiscal Year 2023 (Oct 1, 2022) final rules for Medicare payments. The major rule is, of course, the inpatient hospital
New rule could severely impact the wallets of physicians. Medicare published multiple final rules for 2022 on Nov. 2, with their provisions having been added
While much attention has been focused on the release of the IPPS Final Rule, other final rules might have gone unnoticed. The Centers for Medicare
Providers face increasing Medicare audits when using skin substitute grafts, leaving many unprepared for claim denials and financial liabilities. Join veteran healthcare attorney Andrew B. Wachler, Esq., in this essential webcast and master the Medicare audit process, learn best practices for compliant billing and documentation, and mitigate fraud and abuse risks. With actionable insights and a live Q&A session, you’ll gain the tools to defend your practice and ensure compliance in this rapidly evolving landscape.
Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.
Hospitals face growing challenges in measuring observation metrics due to inconsistencies in classification, payer policies, and benchmarking practices. Join Tiffany Ferguson, LMSW, CMAC, ACM, and Anuja Mohla, DO, FACP, MBA, ACPA-C, CHCQM-PHYADV as they provide critical insights into refining observation metrics. This webcast will address key issues affecting observation data integrity and offer strategies for improving consistency in reporting. You will learn how to define meaningful metrics, clarify commonly misinterpreted terms, and apply best practices for benchmarking, and gain actionable strategies to enhance observation data reliability, mitigate financial risk, and drive better decision-making.
The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.
Physician queries are essential for accurate documentation and claims data, but they are increasingly scrutinized by payors, leading to denials and revenue leakage. This webcast, led by industry expert Cheryl Ericson, RN, MS, CCDS, CDIP, provides actionable strategies to craft compliant queries, reduce denials, and enhance revenue integrity. Attendees will gain insights into clinical validation queries, how to avoid common pitfalls, and learn best practices to defend against query denials. Don’t miss this opportunity to refine your query process and protect your organization’s financial health.
Master the complexities of heart failure coding with this expert-led webcast by Emily Montemayor, CCS, CMBCS, COC, CPC, CPMA. Discover strategies to ensure compliance with ICD-10-CM guidelines, documentation integrity, and capture comorbidities like CKD and hypertension. Learn how to resolve coding challenges, improve documentation practices, and submit clean claims to minimize denials and safeguard your organization’s financial health. With practical insights and real-world examples, this session equips you to prevent revenue leakage, enhance compliance, and secure optimal reimbursement—all while supporting better patient outcomes.
Prepare your organization for the 2025 OPPS updates with expert insights from Tiffani Bouchard, CCS, CRCR, a Revenue Integrity Professional with over 30 years of experience. This webcast will address critical challenges in charge capture and coding, providing clarity on APC policies, C-APC packaging, exclusions, and payer-specific requirements. Attendees will learn actionable strategies to ensure compliance, optimize reimbursement, and mitigate risks of claim denials. Gain the knowledge needed to implement updates effectively, educate your team, and maintain seamless revenue cycle operations in the face of evolving OPPS complexities.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
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