ICD10monitor: Malnutrition Now on PEPPER

Dr. Ronald HirschDecember 20, 2021

Auditors appear to be hungry to deny.

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RACMonitor: Terminology Matters – Site of Service and Status

Dr. Ronald HirschDecember 9, 2021

Sudden reversals from CMS on the Inpatient-Only List and Ambulatory Surgical Center Covered Procedures List have infused confusion into the payment process for providers.

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RACMonitor: To Practice or Not to Practice – The Physician Question

Dr. Ronald HirschNovember 30, 2021

To be a full-time physician advisor, an individual must give up their regular clinical medical practice.

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RACMonitor: Final Rule Reveals No Surprise

Dr. Ronald HirschNovember 30, 2021

The CMS Two-Midnight rules continues to prompt questions.

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Start Preparing Now for the CMS Appropriate Use Criteria (AUC) Program

Maddie CorriganSeptember 28, 2021

The imaging market in the United States is estimated to generate more than $100 billion annually. While approximately 60% of the imaging volume is conducted within hospitals, ...

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RACMonitor: New Drug Makes a Splash – A Swan Dive or a Belly Flop?

Dr. Ronald HirschJune 17, 2021

The soaring cost of new medications and technologies is not news. Insulin was first patented in 1923, but due to incremental changes in the molecule and delivery system, a vial of insulin can still cost hundreds of dollars. When highly active antiretroviral therapy was approved for treatment of HIV in the ...

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RACMonitor: Price New Technology Right, or Else

Dr. Ronald HirschFebruary 20, 2020

There is nothing wrong with adjusting prices to fit your cost-to-charge ratio. New technologies have always posed a financial challenge to hospitals. While they want to provide cutting-edge care to patients, unless a positive margin can be maintained, the costs of those technologies can quickly lead to ...

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RACMonitor: Service Delivery Changing as ASC Use Accelerates

Dr. Ronald HirschNovember 6, 2019

As advances in surgery continue, more and more procedures are destined for the outpatient arena.

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RACMonitor: Shared Decision-Making for Defibrillators

Dr. Ronald HirschJuly 24, 2019

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Practice Audit Targets Become Compliance Risks for Hospitals

Dr. Ronald HirschJune 20, 2019

Twenty four percent of the federal budget was spent on Medicare and Medicaid in 2017.


The Medicare Trust Fund is forecast to be depleted in 2026. Over 8% of Medicare fee-for-service payments in 2017 were made in error. These factors have all led Congress to put more ...

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