The Importance of Clinical Validation Queries: Part III
I recently mentioned that some facilities are receiving payer denials through which a reportable, clinically valid, documented diagnosis is removed from a claim because the
I recently mentioned that some facilities are receiving payer denials through which a reportable, clinically valid, documented diagnosis is removed from a claim because the
Artificial Intelligence (AI) is revolutionizing the healthcare industry, bringing significant advancements in clinical applications, patient care, and administrative efficiency. However, while much of the discussion
Given the recent uptick in immigration enforcement, there is a real risk that ICE may visit your healthcare facility. That acronym, “ICE,” stands for U.S.
Every time we turn on the television, we see politics. Not just campaign commercials, but also nearly every news event – from devastating weather events
The first thing you should know about HIPAA is that it’s HIPAA, not HIPPA, as is commonly seen. There is only one “P,” and that
National healthcare entities are teaming up and speaking out on how to make healthcare better. EDITOR’S NOTE: The following was discussed by Nachimson during last
Recommended next steps for physician practices are discussed by the author. As you have probably heard by now, a federal judge in Texas, U.S. District
Coders can expect to confront new challenges, including new payment models and HIPAA changes. The new year brings new challenges for the healthcare industry. From
Ten things to consider before outsourcing your healthcare needs. I have spent a good part of the past 10 years in the healthcare industry, immersing
How healthcare providers can best prepare for the worst. Editor’s Note: The following is a transcript of a recent segment on Talk Ten Tuesdays by
The aftermath of Florence prompts a review of emergency preparedness We know the 2018 hurricane season is upon us, but we are always unsure of
Achieving accurate and comprehensive coding of such issues is an imperative. Mental and behavioral disorders have recently had a media spotlight shone on them, and
RACmonitor is proud to welcome back Dr. Ronald Hirsch, one of his most requested webcasts. In this highly anticipated session, Dr. Hirsch will break down the complex Two Midnight Rule Medicare regulations, translating them into clear, actionable guidance. He’ll walk you through the basics of the rule, offer expert interpretation, and apply the rule to real-world clinical scenarios—so you leave with greater clarity, confidence, and the tools to ensure compliance.
Bring your questions and join the conversation during this open forum series, live every Wednesday at 10 a.m. EST from June 11–July 30. Hosted by Chuck Buck, these fast-paced 30-minute sessions connect you directly with top healthcare experts tackling today’s most urgent compliance and policy issues.
Fraud convictions don’t just punish a few bad claims; they can wipe out years of reimbursements. Don’t wait for an audit to learn the rules. Join Frank Cohen, MPA, for a live Q&A on spotting red flags, avoiding liability, and protecting your practice. Register now and bring your questions!
Substance abuse is everywhere. It’s a complicated diagnosis with wide-ranging implications well beyond acute care. The face of addiction continues to change so it’s important to remember not just the addict but the spectrum of extended victims and the other social determinants and legal ramifications. Join John K. Hall, MD, JD, MBA, FCLM, FRCPC, for a critical Q&A on navigating substance abuse in 2025. Register today and be a part of the conversation!
Stop revenue leakage and boost hospital performance by mastering risk adjustment and HCCs. This essential webcast with expert Cheryl Ericson, RN, MS, CCDS, CDIP, will reveal how inaccurate patient acuity documentation leads to lost reimbursements through penalties from poor quality scores. Learn the critical differences between HCCs and traditional CCs/MCCs, adapt your CDI workflows, and ensure accurate payments in Medicare Advantage and value-based care models. Perfect for HIM leaders, coders, and CDI professionals. Don’t miss this chance to protect your hospital’s revenue and reputation!
Struggling with ICD-10-CM coding for diabetes and complications? This expert-led webcast clarifies complex combination codes, documentation gaps, and sequencing rules to reduce denials and ensure compliance. Dr. Angela Comfort will provide actionable strategies to accurately link diabetes to complications, improve provider documentation, and optimize reimbursement—helping coders, CDI specialists, and HIM leaders minimize audit risks and strengthen revenue integrity. Don’t miss this chance to master diabetes coding with real-world case studies, key takeaways, and live Q&A!
Uncover critical guidance. HIM coding expert, Kay Piper, RHIA, CDIP, CCS, provides an interactive review on important information in each of the AHA’s 2025 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s fourth quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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