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Navigating Medicare Advantage: Strategies for Hospitals to Tackle Growing Challenges

EvidenceCare

CMS Policy Changes to Reduce Costs Financial pressures are rising as CMS implements the updated Version 28 Hierarchical Condition Category (HCC) model , which introduces changes aimed at limiting types of codes that are most used for up-coding or over-coding to help rein in spending. Document why you believe that. ” – Dr.

Hospital 130
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Preparing for CERT Audits and Practicing Compliant Documentation

EvidenceCare

This comprehensive guide provides hospital and revenue cycle leadership with vital insights on preparing for CERT audits and establishing processes for compliant documentation. This section delves into the specific criteria and expectations set by CERT audits, emphasizing the need for meticulous attention to detail and documentation accuracy.

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New Insights on Medicare Advantage Plans and The Two-Midnight Rule

EvidenceCare

This also means that the medical record must support the reasonableness of the clinician’s admission decision regardless of the total time spent in the facility. Compliant documentation has also become more challenging. This highlights the necessity for hospitals to implement clear and robust compliance documentation practices.

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What do the Neighbourhood Health Guidelines mean for Practice Managers?

Practice Index

While the document sets out a vision for integrated, community-focused care, it provides little in the way of clear guidance for GP practices, leaving them uncertain about how they fit into the evolving system. The publication of the Neighbourhood Health Guidelines for 2025/26 has once again left general practice in the dark.

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Optimizing Revenue Cycle Management and Clinical Documentation Integrity To Avoid Coding Disasters

Relias

Coding and clinical documentation have never been more important in healthcare. “We We rely heavily on our coding quality team to onboard new coders and get them up to speed on our quality standards,” said Jake Hess, Senior Director of Revenue Cycle Shared Services at Spectrum Health. Undercoded Complex Hospital Admissions.

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Optimizing Revenue Cycle Management and Clinical Documentation Integrity To Avoid Coding Disasters

Relias

Coding and clinical documentation have never been more important in healthcare. “We We rely heavily on our coding quality team to onboard new coders and get them up to speed on our quality standards,” said Jake Hess, Senior Director of Revenue Cycle Shared Services at Spectrum Health. Undercoded Complex Hospital Admissions.

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Expert Tips for Accurate Laboratory Data Transcription

CareerStep

Reviewed by Becky Byrns , CHDS, CHDP-S, CEHRS, MSK and Healthcare Documentation, Health and Wellness Program Manager at CareerStep. Precise and accurate documentation is critical in healthcare and medical transcriptionists play a vital role. The transcription key provided by the client showed the lab test and value “IB 4.4.”