Not billing the APP service can result in serious revenue cycle errors. Many providers are still struggling with the non-physician practitioner (NPP) billing rules from
The U.S. is in the middle of flu season this month and the opioid crisis appears unabated. There are several public health issues that are
Interoperability is seen as the first step to using data for health improvement. I expect that 2019 will be the “Year of Interoperability”. The Centers
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
No separate codes for podiatric E&M visits in final rule. The final rule for the 2019 Physician Fee Schedule was released on Nov. 1. Some
CMS issued the final rule on Nov. 1. The Centers for Medicare & Medicaid Services (CMS) final rule includes updates to payment policies, payment rates,
CMS updated Medicare regulations for 2019 EDITOR’S NOTE: Veteran Washington, D.C. observer Stanley Nachimson reported on the final rules from the Centers for Medicare &
CMS announced on Friday a proposed rule to expand telehealth access for patients. Hospitals, doctors, and other providers seeking an edge in today’s highly competitive
The biggest holdout to Sepsis-3 is still CMS. UnitedHealthcare has announced that it will be adopting the Third International Consensus Definition for sepsis and septic
The proposal is on the table as part of proposed E&M changes. EDITOR’S NOTE: The following story was published by RACmonitor on Aug. 16, 2018.
Proposed E&M code changes would impact specialty physicians. Some physicians are probably not very happy with recently proposed changes to the Medicare Physician Fee Schedule.
HATA survey reveals membership dissatisfaction with prior authorization transactions. In a recent report to the U.S. Senate Committee on Finance, the Government Accountability Office (GAO)
CMS CRUSH (Comprehensive Regulations to Uncover Suspicious Healthcare) signals a new era of data-driven program integrity oversight that extends far beyond coding and CDI. As federal scrutiny of claims, documentation, billing practices, provider enrollment, and payment accuracy intensifies, healthcare organizations must be prepared to identify and address vulnerabilities before they result in audits, denials, repayments, or enforcement actions. Join us for this timely webcast to learn what CMS CRUSH could mean for your organization and discover practical strategies to strengthen documentation, claims integrity, compliance readiness, and reimbursement defensibility.
Medicare regulations are complex and even seasoned professionals struggle to apply them consistently. Due to overwhelming demand, Dr. Hirsch returns for Part 2 of Ask Dr. Hirsch: Clarifying Medicare’s Most Misunderstood Rules to answer even more of Medicare’s most misunderstood questions, covering inpatient status, observation, SNF access, Medicare Advantage denials, and more. Join Dr. Hirsch as he provides clear, referenced answers to real-world questions submitted by your peers, helping you navigate Medicare compliance with confidence and clarity.
Traditional utilization management models can no longer keep pace with regulatory shifts, payer scrutiny, and operational pressures. In this webcast, Tiffany Ferguson, LMSW, CMAC, ACM, ACPA-C, introduces an Adaptive Model strategy that modernizes UM through role specialization, technology-driven workflows, and proactive, team-based processes. Attendees will learn how to restructure programs to improve efficiency, strengthen clinical collaboration, and enhance financial performance in a rapidly changing healthcare environment.
Federal auditors are intensifying their focus on inpatient psychiatric facilities, using advanced data analytics to spotlight outliers and pursue high‑dollar repayments. In this high‑impact webcast, Michael Calahan, PA, MBA, Compliance Officer and V.P., Hospital & Physician Compliance, breaks down what regulators are really targeting in IPF-PPS admissions, documentation, treatment and discharge planning. Attendees will learn practical steps to tighten processes, avoid common audit triggers and protect reimbursement and reduce the risk of multimillion-dollar repayment demands.
Artificial intelligence is rapidly transforming healthcare revenue cycle operations, from coding and auditing to compliance and denials. Join industry leaders Pam Warren (MaineHealth) and Raemarie Jimenez (AAPC) for a live fireside chat exploring how AI is changing workflows, workforce roles, payer-provider dynamics, and compliance risk—and what organizations should be doing now to prepare.
Prepare for FY 2027 IPPS changes with a comprehensive 3-part masterclass covering ICD-10-CM/PCS updates, MS-DRG shifts, NTAPs, compliance risks, and reimbursement strategies.
Stay ahead of FY 2027 reimbursement changes with expert analysis of MS-DRG shifts, NTAP updates, Medicare Code Edits, and emerging technologies impacting inpatient payment accuracy.
Stay ahead of FY 2027 ICD-10-PCS changes with expert analysis of new procedure codes, revised guidelines, and high-impact updates affecting reimbursement, compliance, and inpatient coding accuracy.
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