There is a lot of talk lately about the need to follow orders given by a member of law enforcement. I would like to explore
With so much focus within the federal government on abuse, fraud, and waste, I thought it might be helpful to review a couple of federal
Healthcare compliance professionals have long wrestled with the problem of copied-and-pasted notes in medical charts. When clinicians copy-forward prior entries or borrow from templates, auditors
As expected, the federal shutdown began early Wednesday morning. What’s unknown is how long it will continue. Neither congressional Republicans nor Democrats appear to be
Did you know it is Sepsis Awareness Month? To be honest, I didn’t, until a recent Agency for Healthcare Research and Quality (AHRQ) newsletter informed
During a week in which headlines seized on a U.S. Supreme Court decision paving the way for thousands of layoffs of federal health workers, a
Sepsis is one of the most (if not the most) challenging concepts in the International Classification of Diseases, 10th Edition, Clinical Modification (ICD-10-CM), the Health Insurance Portability and Accountability
Clinical documentation integrity (CDI) has matured beyond its initial focus on coding accuracy and Diagnosis-Related Group (DRG) optimization. In 2025, it is central to payer
Today, I’ll be writing about three key areas under review by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG):
Last August, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) reported its findings on a review of certain MS-DRGs
The U.S. Department of Health and Human Services (HHS) recently announced policy changes in response to President Trump’s executive order aimed at gender classifications and
Today, I want to bring attention to an issue that is once again under scrutiny, how hospitals report patient harm events under the Centers for
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.
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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