As the federal government shutdown drags into its fifth week, the collapse of key safety-net supports such as nutrition benefits, health-insurance subsidies, and the disruption
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
Hospitals are about to hit a perfect storm of two powerful climate conditions set both hit in 2026; the One Big Beautiful Bill Act (OBBBA)
As the federal government shutdown drags on, an alarming message began circulating across the healthcare community: “physicians won’t get paid until the government reopens.” The
“PAYGO” (Pay-As-You-Go) refers to a budget enforcement rule designed to impose fiscal discipline: when lawmakers pass legislation that increases mandatory spending or reduces revenue without
Mandatory vs. discretionary spending Antideficiency Act “exceptions” Under the Antideficiency Act (which prohibits federal agencies from incurring obligations without appropriations), there are certain exceptions that
As if their feet were set in concrete, congressional Republicans and Democrats are solidly entrenched in their opposing beliefs about government funding – and come
The Biden Administration has been extremely busy this summer, with the development of new initiatives designed to reform the healthcare system in the U.S. The
The Children’s Health Insurance Program (CHIP) was created as part of the Balanced Budget Act of 1997 (BBA 97) to provide health insurance to children
The Centers for Medicare & Medicaid Services (CMS) just issued the above proposed rule—Managed Care Access, Finance and Quality. Before digging into the rule, I
Skyrocketing rates of improper payments have coincided with historically rapid enrollment in the MA program. It was a Centers for Medicare & Medicaid Services (CMS)
Federal and state lawmakers are scrambling to find solutions. It’s no surprise that the COVID-19 pandemic has continued to impact the healthcare industry generally, but
Get clear, practical answers to Medicare’s most confusing regulations. Join Dr. Ronald Hirsch as he breaks down real-world compliance challenges and shares guidance your team can apply right away.
Federal auditors are zeroing in on Inpatient Rehabilitation Facility (IRF) and hospital rehab unit services, with OIG and CERT audits leading to millions in penalties—often due to documentation and administrative errors, not quality of care. Join compliance expert Michael Calahan, PA, MBA, to learn the five clinical “pillars” of IRF-PPS admissions, key documentation requirements, and real-life case lessons to help protect your revenue.
During this essential RACmonitor webcast Michael Calahan, PA, MBA Certified Compliance Officer, will clarify the rules, dispel common misconceptions, and equip you with practical strategies to code, document, and bill high-risk split/shared, incident-to & critical care E/M services with confidence. Don’t let audit risks or revenue losses catch your organization off guard — learn exactly what federal auditors are looking for and how to ensure your documentation and reporting stand up to scrutiny.
Learn how to navigate the proposed elimination of the Inpatient-Only list. Gain strategies to assess admission status, avoid denials, protect compliance, and address impacts across Medicare and non-Medicare payors. Essential insights for hospitals.
Accurately determining the principal diagnosis is critical for compliant billing, appropriate reimbursement, and valid quality reporting — yet it remains one of the most subjective and error-prone areas in inpatient coding. In this expert-led session, Cheryl Ericson, RN, MS, CCDS, CDIP, demystifies the complexities of principal diagnosis assignment, bridging the gap between coding rules and clinical reality. Learn how to strengthen your organization’s coding accuracy, reduce denials, and ensure your documentation supports true medical necessity.
Denials continue to delay reimbursement, increase administrative burden, and threaten financial stability across healthcare organizations. This essential webcast tackles the root causes—rising payer scrutiny, fragmented workflows, inconsistent documentation, and underused analytics—and offers proven, data-driven strategies to prevent and overturn denials. Attendees will gain practical tools to strengthen documentation and coding accuracy, engage clinicians effectively, and leverage predictive analytics and AI to identify risks before they impact revenue. Through real-world case examples and actionable guidance, this session empowers coding, CDI, and revenue cycle professionals to shift from reactive appeals to proactive denial prevention and revenue protection.
Sepsis remains one of the most frequently denied and contested diagnoses, creating costly revenue loss and compliance risks. In this webcast, Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, provides practical, real-world strategies to align documentation with coding guidelines, reconcile Sepsis-2 and Sepsis-3 definitions, and apply compliant queries. You’ll learn how to identify and address documentation gaps, strengthen provider engagement, and defend diagnoses against payer scrutiny—equipping you to protect reimbursement, improve SOI/ROM capture, and reduce audit vulnerability in this high-risk area.
Only ICD10monitor delivers what you need: updates on must-know changes associated with the FY26 IPPS, including new ICD-10-CM/PCS codes, CCs/MCCs, and MS-DRGs, plus insights, analysis and answers to your questions from two of the country’s most respected subject matter experts.
CYBER WEEK IS HERE! Don’t miss your chance to get 20% off now until Dec. 2 with code CYBER24
