Monitor Mondays

As expected, Monitor Monday continues to focus squarely on healthcare auditing and compliance. During the next live edition of the venerable Internet broadcast, Monitor Monday will examine a range of compliance and...

Artificial intelligence (AI) is dramatically reshaping healthcare by accelerating data analysis, auditing, and documentation. But while it appears to reduce provider burden, AI also strengthens medical necessity...

There has been a noticeable recent surge of activity among data-mining companies or individuals who analyze publicly available government data for potential signals of fraud, rather than the insiders who have...

Program Update: CMS-2451-F has been published in the Federal Register. The proposed rule is effective Oct. 13, 2026. The recently posted rule prohibits federal and state Medicaid and CHIP program dollars from being...

Much like the iconic TV commercials in which the late newscaster John Cameron Swayze would demonstrate on live television how the venerable Timex wristwatch could withstand relentless beatings and “could keep on...

You wear a smartwatch as do so many other Americans. In fact, AI is transforming wearable healthcare devices from simple fitness trackers into powerful tools that collect, analyze, and share health information in real...

The Department of Justice (DOJ) recently announced “data sharing” agreements with the Centers for Medicare & Medicaid Services (CMS), the Department of Homeland Security (DHS) and the Federal Trade Commission (FTC)...

Maybe it’s the summer doldrums that keep otherwise rational people from taking a chance—especially when better alternatives may be available. But according to physician and attorney Dr. John K. Hall, the special guest...

Who would have thought that the otherwise fairly simple Medicare Cost Report could be a serious compliance trap? Some are calling the new Medicare report worksheet a possible precursor to the most significant...

Payer-driven clinical validation is a common reason given by payers to remove ICD-10-CM/PCS diagnosis and procedure codes affecting reimbursement or quality-based payment models (e.g., the Centers for Medicare &...

Behavioral health services continue to face heightened payer scrutiny. The result: inaccurate documentation, coding, and compliance issues. Panacea Healthcare recently hosted a webinar that focused on three high-risk...

There’s a method by which providers can avoid the snare of the latest claim denial strategy to garner attention. Much has been written about the Aetna policy for its “severity inpatient payment” element. Yet almost...

Motivated by the notion that healthcare providers are seeking compliance solutions across the revenue cycle, the producers of Monitor Mondays have invited the CEO of Panacea Healthcare Solutions to serve as the special...

<p>At the heart of a recent lawsuit filed by a physician is whether the medical profession’s understanding and practice of racial concordance is legally defensible.</p><p>“Find-A-Black-Doctor” has served as a platform...

<p>It’s that bright new shiny object few seem to manage to resist: artificial intelligence (AI).</p><p>Here at RACmonitor and Monitor Mondays, we have been reporting on how this disruptive technology has been altering...