Healthcare facilities will need to make adjustments to ensure financial health. The end of COVID-19 public health emergency (PHE) and national emergency on May 11
While these activities oftentimes become challenging, they should help in facilitating reimbursement. This month, we’ll dive into the next steps needed for medical practices to
A highly publicized UHC denial of care led to more questions than answers. By now many have read the ProPublica expose on how UnitedHealthcare (UHC)
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
Remember, “do no harm.” We are all aware of efforts in the healthcare system devoted toward reducing length of stay, but when does that metric
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:
It’s a familiar term, but one that begs to be better understood. What is a Critical Access Hospital (CAH)? Many involved in the healthcare industry
The series begins today on Talk Ten Tuesday with ChristianaCare. The Agency for Healthcare Research and Quality (AHRQ) is the lead federal agency under the
The question often asked is this a payable service or is this a preventative service for Medicare beneficiaries. The Centers for Medicare & Medicaid Services
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
September is National Atrial Fibrillation Awareness Month. I saw a commercial the other day which caught my attention. It was either real people or actors
How to stay compliant in behavioral health screenings. Behavioral health screenings aim to detect mental health symptoms in many seemingly healthy people. This can be
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.
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.
Why should you be focused on SDOH data and ICD-10-CM Z codes? How can you integrate the capture of these elements into your workflows? Get guidance now — before new CMS assessment and reporting mandates take effect.
Set yourself up for appeal success with knowledge about the legitimate presentations of acute heart failure, the common vulnerabilities that auditors identify, the challenges clinical teams face, and how to write a concise and compliant validation query.
What are the changes to the IPO and ACS lists for 2023? What auditor trends do you need to watch out for in the new year? Don’t be caught off guard. Register today for this essential regulatory update led by Dr. Ronald Hirsch.
Take away tried-and-true strategies for ensuring that your Utilization Review committee is working effectively
A massive task lies ahead! Now’s the time to start preparing your case management and utilization review teams for successful implementation of changes contained in the 2023 IPPS, OPPS and MPFS rules.
Learn how to achieve complete, accurate documentation that establishes medical necessity and how to differentiate between billable and non-billable services.
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