In my recent hospital travels, involving working with frontline case management staff, we completed an initial assessment and intervened with a patient who provides one
The PHE has ended and the three-day SNF rule has returned. Following up on my previous article posted in April regarding the return of the
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
The end of the public health emergency (PHE) brings new challenges regarding the old Three-Day rule. The three-day stay for Medicare patients is the requirement
Delays in transitions to post-acute care are a vexing issue. I am continuing to see a significant number of healthcare organizations dealing with denials and
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
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.
In this timely session, Stacey Shillito, CDIP, CPMA, CCS, CCS-P, CPEDC, COPC, breaks down the complexities of Medical Decision Making (MDM) documentation so providers can confidently capture the true complexity of their care. Attendees will learn practical, efficient strategies to ensure documentation aligns with current E/M guidelines, supports accurate coding, and reduces audit risk, all without adding to charting time.
Join Ronald Hirsch, MD, FACP, CHCQM for The PEPPER Returns – Risk and Opportunity at Your Fingertips, a practical webcast that demystifies the PEPPER and shows you how to turn complex claims data into actionable insights. Dr. Hirsch will explain how to interpret key measures, identify compliance risks, uncover missed revenue opportunities, and understand new updates in the PEPPER, all to help your organization stay ahead of audits and use this powerful data proactively.
Breast biopsy procedures may be clinically straightforward but accurately translating them into compliant billing can be anything but. In this focused webcast, Shawn Blackburn, CPC, CPMA, CIC, CRC, CCS-P breaks down how imaging guidance, lesion count, laterality, and payer expectations all impact how these procedures should be reported. Through clear explanations and real-world scenarios, you’ll gain practical insight into aligning clinical workflows with billing requirements, avoiding common pitfalls, and ensuring your documentation supports accurate reimbursement and compliance.
Gain clarity and confidence in OB‑GYN coding with this expert‑led webcast featuring Sherri L. Clayton, RHIT, CSS. You’ll learn how to apply global maternity package rules accurately, select the right CPT codes for procedures and visits, and identify documentation gaps that lead to denials. With practical guidance and real examples, this session helps you strengthen compliance, reduce audit risk, and ensure accurate reimbursement for women’s health services.
Uncover essential coding insights with nationally recognized coding authority Kay Piper, RHIA, CDIP, CCS. Through ICD10monitor’s interactive, on‑demand webcast series, Kay walks you through the AHA’s 2026 ICD‑10‑CM/PCS Quarterly Coding Clinics, translating each update into practical, easy‑to‑apply guidance designed to sharpen precision, ensure compliance, and strengthen day‑to‑day decision‑making. Available shortly after each official release.
Uncover critical guidance on the ICD-10-CM/PCS code updates. Kay Piper reviews and explains ICD-10-CM/PCS coding guidelines in the AHA’s fourth quarter 2026 ICD-10-CM/PCS Coding Clinic in an easy to access on-demand webcast.
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