Are Medicare Advantage Plans Flaunting CMS Rules?
CMS is eliciting comments on MA plans abusing basic Medicare benefits. EDITOR’S NOTE: Patients and healthcare providers can present their personal experiences, devoid of personal
CMS is eliciting comments on MA plans abusing basic Medicare benefits. EDITOR’S NOTE: Patients and healthcare providers can present their personal experiences, devoid of personal
The series begins today on Talk Ten Tuesday with ChristianaCare. The Agency for Healthcare Research and Quality (AHRQ) is the lead federal agency under the
Proposed legislation hopes to add 400 Medicare-funded psychiatric residency positions. While President Biden may have declared an end to the Covid pandemic, the effects it
The Final Rule becomes effective Oct. 25, 2022. The U.S. Departments of Health and Human Services, Labor and Treasury (the Departments) have issued the highly
The challenges of obtaining prior authorizations are further compounded by staffing shortages and a tightened labor market. For proposed rule 87 FR 3475, the Office
Appeals court rules HHS has the authority to reduce payments. In November of last year, the Centers for Medicare & Medicaid Services (CMS) decided to
The concern of the American Academy of Pediatrics (AAP) and the American Medical Association (AMA) now weighs in on the pushback. September is “National Immunization Awareness
Eligible healthcare facilities have begun to recover lost revenue from COVID care for uninsured patients through the U.S. Department of Health and Human Services (HHS)
With concerns of COVID-19 having a disproportionate impact on certain individuals, such as minorities and the elderly, public health experts are requiring more detailed data,
Request is to invoke emergency powers to issue an 1135 disaster and emergency waiver of certain regulations. As updates on the COVID-19 pandemic change day
Healthcare IT executives are monitoring interoperability decisions. EDITOR’S NOTE: At press time, the U.S. Department of Health and Human Services (HHS) announced it is extending
Documenting challenges with EHR usage. At the beginning of the month, I attended an interesting conference through Case Western Reserve University School of Medicine called,
Familiarize yourself with the dramatic 2023 changes to codes, coding guidelines and documentation requirements for evaluation and management (E&M) split/shared and incident-to services.
Dr. Ronald Hirsch breaks down significant 2023 changes to coding and billing requirements for hospital observation services, including new physician E&M coding rules.
Learn how to save your facility hundreds of thousands of dollars in repayments and fines by correctly following CMS requirements for implantable medical device credit reporting. We provide you with all the need-to-know protocols, along with the steps for correct compliance while offering best practices to implement a viable strategy in your facility.
During an exclusive RACmonitor webcast, healthcare attorney Knicole Emanuel will explain in simple, easy-to-understand language the peril of the coming overpayment audits and describe your legal defenses.
Kay Piper reviews the guidance and updates coders and CDISs on important information in the AHA’s fourth quarter 2023 ICD-10-CM/PCS Quarterly Coding Clinic in an easy to access on-demand webcast.
Get access to important guidance on each of the AHA‘s 2023 ICD-10-CM/PCS Quarterly Coding Clinics with information-packed on-demand webcasts available shortly after each official publication.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s third quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Kay Piper reviews the guidance and updates coders on information in the AHA’s second quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Gloryanne Bryant reviews the guidance and updates coders on information in the AHA’s first quarter 2023 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Why should you be focused on SDOH data and ICD-10-CM Z codes? How can you integrate the capture of these elements into your workflows? Get guidance now — before new CMS assessment and reporting mandates take effect.
Set yourself up for appeal success with knowledge about the legitimate presentations of acute heart failure, the common vulnerabilities that auditors identify, the challenges clinical teams face, and how to write a concise and compliant validation query.
Gain a clear understanding of the documentation issues that can sabotage reimbursement for payment hierarchical condition categories (HCCs) and how you can mitigate your risks with a strong CDI program.
What are the changes to the IPO and ACS lists for 2023? What auditor trends do you need to watch out for in the new year? Don’t be caught off guard. Register today for this essential regulatory update led by Dr. Ronald Hirsch.
Take away tried-and-true strategies for ensuring that your Utilization Review committee is working effectively
A massive task lies ahead! Now’s the time to start preparing your case management and utilization review teams for successful implementation of changes contained in the 2023 IPPS, OPPS and MPFS rules.
Learn how to achieve complete, accurate documentation that establishes medical necessity and how to differentiate between billable and non-billable services.