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Hosted by RACmonitor · 🇺🇸 US · EN-US · 408 episodes
Established thought leaders with verified media credentials.
Join Chuck Buck every Monday when he welcomes RACmonitor contributing editors and special guests for the latest regulatory audit news and information from CMS, OIG and OMHA. And gain valuable context and perspective that can only be found when you’re listening to the long-running and popular Monitor Mondays. Register to attend live here: https://racmonitor.medlearn.com/racmonitor/podcasts/
RACmonitor hosts Monitor Mondays, a education show with 408 episodes published.
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 reimburseme
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 & Medicaid
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 are
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 daily
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 g
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. “Find-A-Black-Doctor” has served as a platform for Black,
It’s that bright new shiny object few seem to manage to resist: artificial intelligence (AI). Here at RACmonitor and Monitor Mondays, we have been reporting on how this disruptive technology has been altering the complia
Introducing FOCUS (Fraud Oversight through Careful Use of Statistics) . The U.S. Department of Justice (DOJ) has launched a new initiative in response to the surge in False Claims Act qui tam filings by data miners. Toda
Healthcare compliance has entered the machine-learning era, and most organizations have not yet noticed. Providers are using artificial intelligence (AI) to generate documentation, surface reimbursable conditions, and ti
Documenting and coding sepsis has challenged virtually everyone in healthcare ever since Sepsis-3 redefined the condition in 2016 as a “life-threatening organ dysfunction due to a dysregulated host response to infection.
The recent U.S. Supreme Court decision in Chiles v. Salazar doesn’t really close the case – but it also doesn’t really leave it open. The 8-1 decision, in which the nation’s highest court ruled that a Colorado ban on so-
Artificial intelligence (AI) is clearly here to stay – it’s now an integral part of healthcare. From coding and clinical validation to payer denials and appeals, AI is often a form of power upon which decisions are made
When the U.S. Supreme Court overturned Chevron deference, it promised to restore judicial independence and limit agency overreach. But in Medicare administrative proceedings, that promise remains unfulfilled. Tune in to
National Doctor’s Day will bring a double whammy this coming Monday when the venerable Monitor Monday continues its recognition of the occasion with a pair of featured speakers: Drs. Drew Updike and Christopher Boyle. Th
Artificial intelligence (AI) is becoming part of how clinical documentation is reviewed across healthcare, from coding and clinical validation to payer denials and appeals. In many cases, AI is influencing decisions behi
Aetna is just the latest in a long list of healthcare entities to settle False Claims Act (FCA) allegations with a massive settlement. The insurer, one of the nation’s largest, recently agreed to pay $117.7 million to re
Imagine machine learning and natural language processing deployed to audit claims. Today, it’s the new reality. Autonomous coding is dramatically altering the treacherous auditing landscape. So, how can you protect your
Healthcare documentation is no longer written for a single audience. Today, the medical record must simultaneously meet federal regulatory requirements and the coverage expectations of individual payers. While these syst
The Centers for Medicare & Medicaid Services (CMS) has launched a new initiative titled Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH). CRUSH is a sweeping fraud prevention program. In an official new
Prior authorizations among Medicare Advantage plans have drawn criticism and concern from patients, providers, lawmakers, and regulators. But hospitals and doctors are uniquely positioned to advocate for their patients’
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Monitor Mondays is hosted by RACmonitor. The show is categorised under education (government) and has published 408 episodes.
Monitor Mondays has published 408 episodes.
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