Numerous updates from CMS include post-acute transfers to skilled nursing. In the last week there have been a lot of updates that have come from
The unwinding of Medicaid coverage is something to look for. During the COVID-19 pandemic, our health system saw significant benefits under the federal public health
Recently, the Centers for Medicare & Medicaid Services (CMS) announced that it was cracking down on poorly performing skilled nursing facilities (SNFs) by making changes
This category of E&M services will have three subcategories instead of the current four. EDITOR’S NOTE: The American Medical Association (AMA) announced major revisions to Evaluation
Comments on these proposed rules are due by June 7. Hospice payment rates, as well as those for skilled nursing facilities (SNFs), constitute the subjects
Alexander v. Azar Reappears; Condition Code 44 appeals could be back in court. Author’s Note: Thanks to the Center for Medicare Advocacy for alerting me
The move comes amid localized spikes in COVID-19 cases occurring nationwide. Federal officials said Friday that they are ending an emergency blanket waiver intended to
March 23, 2020—The Centers for Medicare & Medicaid Services (CMS) has clarified its position on the use of swing beds, saying that swing beds can
Under PDPM, reimbursement will be driven by coding and documentation. South Florida has historically been a hotbed of healthcare fraud, and there is a long
Oct. 1, 2019, marks the beginning of a new era of billing for skilled nursing facilities (SNFs). EDITOR’S NOTE: This article was published on Aug.
Big ICD-10 changes coming soon to the SNF world. In July 2018, the Centers for Medicare & Medicaid Services (CMS) finalized a new case-mix classification
Proposed rules also include new payment models. The Centers for Medicare & Medicaid Services (CMS) has been quite busy these last few weeks issuing the
Dr. Ronald Hirsch provides critical details on the new Medicare Appeal Process for Status Changes for patients whose status changes during their hospital stay. He also delves into other scenarios of hospital patients receiving custodial care or medically unnecessary services where patient notifications may be needed along with the processes necessary to ensure compliance with state and federal guidance.
Healthcare organizations face complex regulatory requirements under the No Surprises Act and Price Transparency rules. These policies mandate extensive fee disclosures across settings, and confusion is widespread—many hospitals remain unaware they must post every contracted rate. Non-compliance could lead to costly penalties, financial loss, and legal risks. Join David M. Glaser Esq. as he shows you how to navigate these regulations effectively.
Protect your facility from unwanted audits! Join Becky Jacobsen, BSN, RN, MBS, CCS-P, CPC, CPEDC, CBCS, CEMC, and take a deep dive into both the CMS and AMA guidelines for reporting post operative pain blocks. You’ll learn how to determine if the nerve block is separately codable with real life examples for better understanding. Becky will also cover how to evaluate whether documentation supports medical necessity, offer recommendations for stronger documentation practices, and provide guidance on educating providers about documentation requirements. She’ll include a discussion of appropriate modifier and diagnosis coding assignment so that you can be confident that your billing of post operative pain blocks is fully supported and compliant.
During this RACmonitor webcast Dr. Ronald Hirsch spotlights the areas of the OIG’s Work Plan and the findings of their most recent audits that impact utilization review, case management, and audit staff. He also provides his common-sense interpretation of the prevailing regulations related to those target issues. You’ll walk away better equipped with strategies to put in place immediately to reduce your risk of paybacks, increased scrutiny, and criminal penalties.
Join Beth Wolf, MD, CPC, CCDS, for an in-depth webcast on the FY2025 spinal fusion MS-DRG updates. Discover key changes in DRG classification, understand impacts on documentation and CMI, and learn strategies to ensure compliance.
Join Angela Comfort, DBA, MBA, RHIA, CDIP, CCS, CCS-P, as she presents effective strategies to strengthen collaboration between CDI, coding, and quality departments in acute care hospitals. Angela will also share guidance on implementing cross-departmental meetings, using shared KPIs, and engaging leadership to foster a culture of collaboration. Attendees will gain actionable tools to optimize documentation accuracy, elevate quality metrics, and drive a unified approach to healthcare goals, ultimately enhancing both patient outcomes and organizational performance.
Optimize your outpatient clinical documentation and gain comprehensive knowledge from foundational practices to advanced technologies, ensuring improved patient care and organizational and financial success. This webcast bundle provides a holistic approach to outpatient CDI, empowering you to implement best practices from the ground up and leverage advanced strategies for superior results. You will gain actionable insights to improve documentation quality, patient care, compliance, and financial outcomes.
Enhancing outpatient clinical documentation is crucial for maintaining accuracy, compliance, and proper reimbursement in today’s complex healthcare environment. This webcast, presented by industry expert Angela Comfort, DBA, RHIA, CDIP, CCS, CCS-P, will provide you with actionable strategies to tackle complex challenges in outpatient documentation. You’ll learn how to craft detailed clinical narratives, utilize advanced EHR features, and implement accurate risk adjustment and HCC coding. The session also covers essential regulatory updates to keep your documentation practices compliant. Join us to gain the tools you need to improve documentation quality, support better patient care, and ensure financial integrity.
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