Quality & Regulatory

By Brian D. Murphy

In Part 1 of this series I introduced the developing story of UnitedHealth Group, Inc. vs. the United...Read More »

What happens to physicians who did not meet the qualification thresholds for the advanced Alternative Payment Models (APM) track of MACRA’s...Read More »

CMS released a new Program for Evaluating Payment Patterns Electronic Report (PEPPER) with...Read More »

By Cheryl Manchenton, RN, BSN
From a bird’s–eye view, your CDI program may be a well-oiled machine. CDI specialists pose queries,...Read More »

FEATURES

8 The denials landscape: Physicians’ perspectives

14 CDI specialists see an inside scoop on denials...Read More »

Only 28% of CDI specialists are involved in the denials prevention and appeals process, according to a poll on...Read More »

A patient comes into the hospital, so sick that there’s likely no coming back. The physicians do everything they can, but the patient expires....Read More »

By Rachel Strom, RN
Yes, I’ll admit it, I used to be one of those people, I am a former Medicare Administrative Contractor (MAC)...Read More »

The fiscal year (FY) 2018 IPPS final rule,...Read More »

A May 2017 HealthLeaders Intelligence Report on Value-Based Readiness found that 74% of surveyed providers depend on fee-for-service...Read More »