
When the Doctor Crossed the Line
Like the virtual line between actors and the audience, an invisible line exists between doctors and patients. Yet, Dr. Juliet B. Ugarte Hopk...
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Like the virtual line between actors and the audience, an invisible line exists between doctors and patients. Yet, Dr. Juliet B. Ugarte Hopk...

The recent $14.1 million False Claims Act settlement against Complete Health Partners Holdings, a management services organization operating...

Utilization managers (UMs) have long served as a resource for clinicians determining the appropriate patient status. Key considerations incl...

Tuesday, July 28 marks the 700th live edition of the commemorative Talk Ten Tuesdays broadcast. And in honor of this celebration, the ICD10m...

The squeeze is on. Federal enforcement is intensifying, with behavioral health agencies facing heightened scrutiny following revealing repor...

The secondary review: Corrective Backup? Or a layer of quality assurance? Given that clinical documentation integrity (CDI) invariably has i...

What happens when the Inpatient-Only (IPO) List goes away? The entire list is expected to be eliminated Jan. 1, 2028. This will necessitate...

Public comments have closed on the 2026 AHIMA-ACDIS Query Practice Brief. In other words, the time to talk is over, and the time to listen h...

After a two-year hiatus, the PEPPER (Program for Evaluating Payment Patterns Electronic Report) is back. It’s now available to all acute car...

Nearly every American hospital has at least one physician advisor. So, how does the physician advisor at your facility measure up? We reache...

There’s a quiet battle taking place, with no field hospitals for the sick and wounded, and no bloodshed. But the stakes are high, and the lo...

Although one could conclude that artificial intelligence (AI) is a relatively new technology in healthcare, the reality is that AI has been...

At last, the secrets of healthcare technology will be revealed during a fresh new two-part series, especially written for the accomplished h...

The role of physician advisor began as a friendly clinical champion for case/utilization management and clinical documentation integrity (CD...

What’s new for the proposed 2026 American Health Information Management Association/Association of Clinical Documentation Integrity Speciali...

Learning how daily payer logs can help you and your utilization review (UR) team identify denials earlier, strengthen communication between...

The Association of Clinical Documentation Integrity Specialists (ACDIS) will conclude the formal agenda of its Annual Conference at the clos...

Many of you dedicated healthcare professionals no doubt often find yourselves wearing many different hats, as does Penny Jefferson, cohost o...

As federal oversight of risk adjustment and documentation practices intensifies, healthcare organizations are facing new scrutiny regarding...

A recent False Claims Act case is raising an important question for CDI professionals: what if the diagnosis is clinically valid, but the pr...