When is the last time your hospital, health system or organization looked at codes and clinical documentation to ensure everything was compliant with law and best practices? If revenue cycle teams are ...

In September 2014, the U.S. Dept. of Health and Human Services’ Office of the Inspector General (OIG) published its audit of Tulare Regional Medical Center, an acute care hospital in California. In ...

Coding accuracy isn’t just about reimbursements: How compliance programs promote a quality, culture and positive brand image Without medical coders, the healthcare system would come to a halt.

Practical challenges for applying MISRA and AUTOSAR coding requirements. The importance of the right development and tooling approaches. The key ideas behind MISRA Compliance, where the same thought ...

The 2026 updates from CMS and AMA introduce sweeping CPT, HCPCS, and regulatory changes that directly affect reimbursement, compliance, and operational planning. Key shifts include a dual conversion ...

As an attorney specializing in healthcare reimbursement, I have focused my practice on helping healthcare providers navigate the Center for Medicare and Medicaid (“CMS”) administrative appeal process.

Healthcare reform and technological advances constantly add new tasks for ambulatory surgery center billers and coders and make compliance a challenge. George Kaplinksi is the vice president of ...

Noncompliant coding is a more significant risk to the revenue cycle than providers may realize, accounting for $36 billion in annual lost revenue, denials, and fines. In 2019 alone, the CMS and the ...

In regulated industries, DevSecOps teams have to satisfy strict audit, traceability and documentation requirements that can turn security reviews into a drag on delivery.