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
In a recent statement from Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure, she expressed support for the Food and Drug Administration’s (FDA’s)
New rule allows Medicaid and CHIP programs to pay specialists directly when a primary-care provider requests their advice. New guidance issued Jan. 5 by the
Most providers understand the “No Surprises” requirements for insured patients. Effective as of Jan. 1, 2022, uninsured (or self-pay) consumers are also protected from unexpected high
The cost of medical care services is now up 6.5 percent from last September. The recently released Consumer Price Index, or CPI, did not exactly
AHIMA released its CDI Practice Brief Monday. At Yom Kippur services, I found myself thinking about the question Dr. Ronald Hirsch posed to me 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 U.S. ranks as the country with the highest chance of negative maternal outcomes amongst other similarly developed countries. EDITOR’S NOTE: Cate Brantley reported this
The Supreme Court ruling strikes down Medicare payment cuts. On June 15, the U.S. Supreme Court sided with hospital groups in a case challenging the 340B payment
The discounted drug program is viewed as vital for vulnerable populations. With all eyes on the U.S. Supreme Court, as pending landmark decisions on abortion
A woman who thought she was paying four figures for elective spinal fusion surgery filed suit when her provider demanded six figures. A recent legal
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.
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