HFM: Utilization Review Hurting Results Fixing Inpatient Admissions

Dr. Ronald HirschJune 13, 2022

Since 2004, the Centers for Medicare and Medicaid Services (CMS) has allowed hospitals to change the status of a patient who was improperly admitted as an inpatient to outpatient by following a process commonly known as 

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Healthcare IT Today: Downstream Impacts of EHR Optimization

John LynnJune 7, 2022

Yesterday we shared 6 EHR optimization tips with you.  Today, we’re going to look at the ecosystem of technology that interacts with the EHR and makes the EHR experience better (or worse if ...

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RACMonitor: OIG Report on Medicare Advantage Organization Denials

Dr. Ronald HirschMay 11, 2022

The OIG’s determinations seem to fly in the face of the basic concepts of medical necessity.

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RACMonitor: Latest Development - The Intersection of IPPS and SDoH

Dr. Ronald HirschMay 2, 2022

CMS is requesting comments on getting better data on the social determinants of health (SDoH).

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US News & World Report: 8 Questions to Ask Before Paying Medical Bill

Maryalene LaPonsieApril 12, 2022

A single stay in the hospital can result in a bewildering array of bills covering a number of services and providers. Some statements may provide scant details to justify charges while others could include descriptions or codes that make little sense to the average person.

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RACMonitor: When Does a Patient Become an Inpatient?

Dr. Ronald HirschApril 8, 2022

With Medicare regulations, there appears to be no right answer.

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Entrepreneur Magazine: Top 10 CTOs To Watch In 2022

Srivatsa KRMarch 17, 2022

CTOs are undoubtedly the backbones of the most successful companies.

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HFM: Revenue Cycle Staff Shortages Push Leaders to Adapt Quickly

Lisa EramoMarch 8, 2022

The pandemic-driven workforce shortage is leading to significant changes in revenue cycle management operations at many hospitals and health systems.


Changes include the greater use of remote workers, soaring wage costs, implementation of sign-on bonuses, the outsourcing of jobs and greater use of automation, all of which ...

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HFM: How LifePoint Health Revamped its Revenue Cycle

Jason RossMarch 7, 2022

After two years of operating during the pandemic, hospital organizations such as LifePoint Health continue to face financial challenges. 


Labor and supply costs increased by 14% and 13%, respectively, between 2020 and 2021, and Kaufman Hall projects hospitals’ losses for 2021 could amount to $53 billion under an ...

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ACPA Newsletter: Cancelled Surgery – Change the Status?

Dr. Ronald HirschFebruary 9, 2022

The flip flop by CMS on the Inpatient Only List (IOL) has left many with their head spinning, and with good reason. First they remove 298 surgeries from the list, including many where patients always stay over two midnights, leading to education sessions and program redesigns to get status correct. Then CMS says “never mind” and puts most of ...

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