According to a new report by Patients for Affordable Drugs, Medicare spent an astonishing $46 billion on just two blood thinners between 2015 and 2020.
The Centers for Medicare & Medicaid Services (CMS) has begun implementing the Review Choice Demonstration (RCD) for Inpatient Rehabilitation Facilities (IRFs). The project began last
The OPPS proposal did not feature reference to several high-profile issues industry leaders have been awaiting reform on. Federal officials yesterday unveiled a pair of
EDITOR’S NOTE: ICD10monitor Publisher and Talk Ten Tuesdays program host Chuck Buck recently asked longtime national ICD10monitor correspondent Mark Spivey to produce a feature article on
In the third quarter of 2023 – specifically, from July 1 to Sept. 30 – there are 43 drugs covered under Medicare Part B that
On April 2, my 92-year-old father sustained a fall in his assisted living facility (ALF), which resulted in an emergency department evaluation. Fortunately, he hadn’t
Action taken by payers is seen as increasing. Having been on the receiving end of audits, and also having been an individual who has conducted
The 2024 inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) rule updates Medicare payments and policies. Is April the
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
Providers face increasing Medicare audits when using skin substitute grafts, leaving many unprepared for claim denials and financial liabilities. Join veteran healthcare attorney Andrew B. Wachler, Esq., in this essential webcast and master the Medicare audit process, learn best practices for compliant billing and documentation, and mitigate fraud and abuse risks. With actionable insights and a live Q&A session, you’ll gain the tools to defend your practice and ensure compliance in this rapidly evolving landscape.
Dr. Ronald Hirsch dives into the basics of Medicare for clinicians to be successful as utilization review professionals. He’ll break down what Medicare does and doesn’t pay for, what services it provides and how hospitals get paid for providing those services – including both inpatient and outpatient. Learn how claims are prepared and how much patients must pay for their care. By attending our webcast, you will gain a new understanding of these issues and be better equipped to talk to patients, to their medical staff, and to their administrative team.
Hospitals face growing challenges in measuring observation metrics due to inconsistencies in classification, payer policies, and benchmarking practices. Join Tiffany Ferguson, LMSW, CMAC, ACM, and Anuja Mohla, DO, FACP, MBA, ACPA-C, CHCQM-PHYADV as they provide critical insights into refining observation metrics. This webcast will address key issues affecting observation data integrity and offer strategies for improving consistency in reporting. You will learn how to define meaningful metrics, clarify commonly misinterpreted terms, and apply best practices for benchmarking, and gain actionable strategies to enhance observation data reliability, mitigate financial risk, and drive better decision-making.
The 2025 Medicare Physician Fee Schedule brings significant changes to payment rates, coverage, and coding for physician services, impacting practices nationwide. Join Stanley Nachimson, MS., as he provides a comprehensive guide to understanding these updates, offering actionable insights on new Medicare-covered services, revised coding rules, and payment policies effective January 1. Learn how to adapt your practices to maintain compliance, maximize reimbursement, and plan for revenue in 2025. Whether you’re a physician, coder, or financial staff member, this session equips you with the tools to navigate Medicare’s evolving requirements confidently and efficiently.
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.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s third quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
Uncover critical guidance. Kay Piper provides an interactive review on coding guidelines and more in the AHA’s second quarter 2025 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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