They say artificial intelligence (AI) will improve medicine. But how good is it? Recently, several independent studies tested the leading AI systems, including the PrIME-LLM
Let me start with some follow-up on a topic I have written about before: the widening of the use of “against medical advice” (AMA) to
The 30th Annual Compliance Institute for the Health Care Compliance Association (HCCA) is scheduled to take place in Orlando next week. If you are there,
Sometimes you want to be contacted by the US Department of Health and Human Services (HHS) Office of Inspector General (OIG). I realize that
EDITOR’S NOTE: This column features spoilers for the current season of The Pitt, and the sentiments reflected therein are the author’s own – not necessarily
A recent federal lawsuit filed by AbbVie may prove to be one of the most consequential developments in the evolution of the 340B Drug Pricing
There is no question that a proper diet is an important part of achieving and maintaining good health. But there are limits to that notion.
A new study from Georgetown University examined the currently publicly available data for the No Surprises Act (NSA) independent dispute resolution (IDR) process during the
When I was a resident, no one ever said to me, “Pay attention. One day this will matter when you are explaining medical necessity to
As we enter the first year of post-Loper Bright v. Raimando, the landmark U.S. Supreme Court decision overturning so-called Chevron deference, healthcare providers should push
It just seems that a week does not go by when an insurance company doesn’t develop a new policy that leads to confusion in the
Combat is often described as hours of boredom intermixed with moments of sheer terror. I fear that that metaphor is increasingly applicable to Medicare enrollment. Few
A single CDM error can lead to missed revenue, billing issues, denials, and compliance concerns. Learn the fundamentals of effective Charge Description Master (CDM) management and build a stronger foundation for accurate, consistent charge decisions.
Join Michael Calahan, PA, MBA for this radiation oncology coding and compliance webcast as he explains the fundamentals of coding, billing, reporting, and documentation for hospital outpatient and professional services. Learn how the 2026 radiation therapy coding changes affect current practices, how to distinguish technical and professional services, and how to address bundling, units, frequency, modifiers, and documentation requirements. Michael will also help you identify radiation oncology coding and billing vulnerabilities that could lead to denials, overpayments, repayment demands, or federal audit exposure.
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The Two-Midnight Rule helps you navigate short-stay admissions, patient status, and evolving 2026-2027 requirements, while CMS CRUSH explores the next wave of program integrity, payment oversight, and data-driven scrutiny.
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The 2027 CMS policy changes will impact case management, utilization review, reimbursement, and patient status decision-making long before they officially take effect. Join nationally recognized physician advisor Dr. Ronald Hirsch as he explains the finalized and proposed inpatient and outpatient rule changes, expanding bundled payment initiatives, payment updates, and evolving payer expectations. Gain practical guidance to help your organization prepare early, strengthen compliance, reduce reimbursement risk, and confidently navigate the transition to 2027.
What happens when everyone reviews the same chart, but reaches a different conclusion? In this case-based clinical documentation integrity (CDI) webcast, Penny Jefferson examines how documentation involving clinical support, timing, causation, linkage, and terminology can produce very different outcomes for ICD-10 coding, reimbursement, quality, risk adjustment, medical necessity, denials, and compliance. Using cases involving postoperative respiratory failure, severe malnutrition, and encephalopathy, you’ll learn the practical CLEAR framework to help attendees learn to evaluate whether a diagnosis is codeable, consistent, specific, reportable, and ultimately defensible across the different teams and systems that rely on the medical record.
Spinal fusion cases are among the most complex inpatient procedures to code, where even minor ICD-10-PCS errors can affect MS-DRG assignment, reimbursement, compliance, and audit outcomes. This practical webcast provides a step-by-step framework for interpreting operative reports, assigning accurate ICD-10-PCS codes, recognizing documentation gaps, and confidently coding complex fusion procedures. You’ll leave with practical tools that improve coding accuracy, reduce denials and audit risk, and strengthen documentation-driven reimbursement decisions.
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.
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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.
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