RACMonitor: CMS Pushes Forward with Guidance on Alzheimer’s Drug
Dr. Ronald HirschJanuary 20, 2022
Clinical trials for the medication showed no significant improvement in patients.
ICD10monitor: Malnutrition Now on PEPPER
Dr. Ronald HirschDecember 20, 2021
Auditors appear to be hungry to deny.
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.
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.
RACMonitor: Final Rule Reveals No Surprise
Dr. Ronald HirschNovember 30, 2021
The CMS Two-Midnight rules continues to prompt questions.
HFMA NJ Chapter Journal: Keep Your Eye on the Ball - Fee Schedules are Missing the Mark
Dr. Ronald HirschOctober 19, 2021
When the Centers for Medicare & Medicaid Services (CMS) finalized the 2021 Outpatient Prospective Payment System Final Rule, they included their plan to abolish the inpatient-only list over the next four years, starting this year with the removal of all orthopedic procedures and ...
Journal of AHIMA: Appeals, Denials, HIM and Utilization Review - A Winning Combination
Dr. Ronald HirschAugust 23, 2021
Many claim that people in the United States have access to the best healthcare in the world. And while that is easily refuted with data from multiple sources, there is no question that the United States has one of the most complex healthcare delivery systems in the ...
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 ...
RAC Monitor: Rebilling Non-Medicare Inpatient Claims
Dr. Ronald HirschMarch 26, 2021
It is crucial to understand the differentiation between a denial for lack of medical necessity and a denial for incorrect status.
RACMonitor: Deconstructing the Concept of Condition Code 44
Dr. Juliet Ugarte HopkinsMarch 3, 2021
Dear Readers,
