Managed Care – How Did We Get Here?
The origins of Health Maintenance Organizations (HMOs) can be traced back to the early 20th century, when prepaid group practice models began to emerge. These
The origins of Health Maintenance Organizations (HMOs) can be traced back to the early 20th century, when prepaid group practice models began to emerge. These
Medical coding is an essential aspect of healthcare in that it translates diagnoses, procedures, medical services, and equipment into alphanumeric codes. The processes involved in
There is conflicting advice for colorectal cancer screening. March was National Colorectal Cancer Awareness Month, intended to highlight the importance of screening for colorectal cancer.
Delays in transitions to post-acute care are a vexing issue. I am continuing to see a significant number of healthcare organizations dealing with denials and
Frequently, Type 2 MI is inconsistently documented. February is American Heart Month, a time to raise awareness of cardiovascular health and a time to shine a
About 600 rural hospitals in America are at risk of closing. As part of this ongoing series of “What’s Happening to Rural Hospitals?” today’s topic
This upcoming year, take time to take care of yourself. Two days before Thanksgiving, I noticed flashing in my visual field. I was talking to
Applying the Four Season analogy to your personal life. I would like to share with you my “Four Season Analogy.” It is a scenario we
Learning a new culture requires one’s attitude towards the change Culture is something that we are exposed to everyday no matter what age we are,
Give me a lever long enough and a fulcrum on which to place it, and I shall move the world.” -Archimedes The current structure of
To understand this dynamic, you need to know who the customer is. One of the key questions arising from looking at financial statements is this:
Dear Fellow Colleagues, We here at RACmonitor and ICD10monitor would like to take the opportunity today to wish you and your families a very happy
Dr. Ronald Hirsch provides tried-and-true strategies and insight into outpatient in hospital bed stays including determining the applicable definition, who uses it, and when and how to bill for this circumstance, solidified with concrete case examples and expert insight.
Practical solutions for CDM departments to protect your hospital’s revenue.
This webcast teaches hospitals how to comply with CMS price transparency rules and compare their rates with peer hospitals. It covers creating a compliant machine-readable file, comparing negotiated rates, and improving pricing decisions.
The No Surprises Act (NSA) presents a challenge for hospitals and providers who must provide Good Faith Estimates (GFEs) for all schedulable services for self-pay and uninsured patients. Compliance is necessary, but few hospitals have been able to fully comply with the requirements despite being a year into the NSA. This webcast provides an overview of the NSA/GFE policy, its impact, and a step-by-step process to adhere to the requirements and avoid non-compliance penalties.
This expert-guided webcast will showcase tips for providers to ensure appropriate capture of the work performed for a visit. Comprehensive examples will be given that demonstrate documentation gaps and how to educate providers on the documentation necessary to appropriately assign a level of service. You will gain clarification on answers regarding emergency department and urgent care coding circumstances as well as a review of how/when it is appropriate to code for E&M in radiology and more.
Set yourself up for financial and compliance success with expert guidance that breaks down the impactful changes including MS-DRG methodology, surgical hierarchy updates, and many new technology add-on payments (NTAPs). Identify areas of potential challenge ahead of time and master solutions for all 2024 Proposed IPPS changes.
Do you struggle with selecting and appending the correct modifier for your medical claims? Join our must-attend webinar, “Mastering Modifier Usage: Preventing Denials and Ensuring Compliance” to reduce claim denials and improve your reimbursement rates.
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.
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.