Talk Ten Tuesdays

Епизоде

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  Learn Why “Inpatient” and “Observation” are Insufficient Indicators 15.09.2026 29мин

  Clear, rationale-based documentation in utilization review (UR), especially for status recommendations by physician advisors, is essential. During the next edition of Talk Ten Tuesdays, Dr. Juliet Ugarte Hopkins, Chief Medical Officer for Phoenix Medical Management, Inc., will explain why one-word descriptors such as “inpatient” or “observation” are insufficient when cases are later reviewed, denied, appealed, or audited. She’ll also highlight how physician advisor notes should connect the pa...
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  Brief Segment: AHIMA-ACDIS Practice Brief 01.09.2026 34мин

  The American Health Information Management Association (AHIMA) and the Association of Clinical Documentation Integrity Specialists (ACDIS), an HCPro professional community, have released the 2026 update to Guidelines for Achieving a Compliant Query Practice. The practice brief’s guidance applies equally across inpatient, outpatient, ambulatory, and professional fee environments, with specific considerations for outpatient and ambulatory contexts noted throughout. During this exclusive Talk Te...
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  ICD-10-CM/PCS Coordination and Maintenance Committee Fall Meeting: Preview of Coming Attraction Coming Tuesday 25.08.2026 30мин

  The Center for Disease Control and Prevention (CDC) along with the National Center for Health Statistics (NCHS) jointly announced the agenda of its September 15-16, 2026, Coordination and Maintenance committee meeting. During the live event, the public can view and provide feedback on proposed amendments to the International Classification of Diseases, 10th Edition (ICD-10), Clinical Modification (CM), and the HIPPA-sanctioned diagnosis reporting convention required on most provider claims. ...
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  When the Doctor Crossed the Line 18.08.2026 31мин

  Like the virtual line between actors and the audience, an invisible line exists between doctors and patients. Yet, Dr. Juliet B. Ugarte Hopkins will explore the sharp contrast in how pediatric and adult medicine address patient pain and fear. Reflecting on her own career choices and a lifelong needle phobia stemming from childhood medical experiences, Dr. Ugarte Hopkins will highlight how pediatric care could (and should) routinely integrate proactive comfort measures to ease distress, while,...
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  The False Claims Act and the Role Played by Coders 11.08.2026 32мин

  The recent $14.1 million False Claims Act settlement against Complete Health Partners Holdings, a management services organization operating provider groups in Florida, Alabama, and Colorado, brings to light the role coders can play in False Claims Act cases. In this instance, it was alleged that Complete Health Partners Holdings directed physicians to add high-value, risk-adjusting codes for Drug and Alcohol Dependence and Major Depressive, Bipolar, and Paranoid Disorders to the medical reco...
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  Hospital’s Latest Status Symbol: Utilization Managers 04.08.2026 32мин

  Utilization managers (UMs) have long served as a resource for clinicians determining the appropriate patient status. Key considerations include which clinicians are involved, how communication occurs, and how status orders are entered. Because these processes can vary widely, it is essential to understand what is compliant, what carries risk, and what is simply not allowed. That’s why it’s essential to stay current on the latest developments in utilization management. So, listen and learn whe...
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  700th Commemorative Live Broadcast of Talk Ten Tuesday 28.07.2026 1ч 1мин

  Tuesday, July 28 marks the 700th live edition of the commemorative Talk Ten Tuesdays broadcast. And in honor of this celebration, the ICD10monitor producers of the popular news and information service have invited Dennis Jones, the assistant vice president of revenue cycle for Jefferson Health, to be the guest host. During the first half of the broadcast, our other well-known subject-matter experts will also join the broadcast with more news to report, including the following: • Tech Report: ...
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  Behavioral Health Amid the Coding Crisis 21.07.2026 29мин

  The squeeze is on. Federal enforcement is intensifying, with behavioral health agencies facing heightened scrutiny following revealing reports from the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG). According to the OIG, there have been numerous fraud cases involving false claims and falsified documentation. But among this emerging sturm und drang, there is a critical role that health information management (HIM) can play – as you and your team will lea...
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  Understanding the Misunderstanding: Secondary Reviews 14.07.2026 28мин

  The secondary review: Corrective Backup? Or a layer of quality assurance? Given that clinical documentation integrity (CDI) invariably has interpretative variability, a secondary review is intended to bring consistency to complex issues, according to the Talk Ten Tuesday special guest, Mary McGrady, vice president of CDI for Accuity Health. During the next live edition of the popular Internet broadcast, Mary McGrady will clear up the misunderstanding of the secondary review. Other well-known ...
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  Twin Horns of a Dilemma: Inpatient Status without the IPO List 07.07.2026 28мин

  What happens when the Inpatient-Only (IPO) List goes away? The entire list is expected to be eliminated Jan. 1, 2028. This will necessitate careful, patient-specific status determinations, rather than automatic assumptions based only on the procedure being performed. The removal of a procedure from the IPO list does not mean that every such procedure must be classified as “outpatient.” Instead, the clinical team must evaluate the individual patient’s medical condition, functional needs, home ...
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  ACDIS-AHIMA Query Practice Brief: No More Public Comment, so Listen to Talk Ten Tuesday 30.06.2026 36мин

  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 has begun. During the next live edition of the popular Internet broadcast Talk Ten Tuesdays, produced by ICD10monitor, you can hear out senior healthcare attorney Richelle Marting as she leads a reflection session to review key themes from the Brief. She will also share her analysis of those themes, including the concept of a “compliant” and “non-compli...
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  Spice Up Documentation: Bring on the PEPPER 23.06.2026 35мин

  After a two-year hiatus, the PEPPER (Program for Evaluating Payment Patterns Electronic Report) is back. It’s now available to all acute care hospitals and critical access hospitals. During the next live edition of Talk Ten Tuesday, Dr. Ronald Hirsch will share some insights that listeners can get from their PEPPER to improve their hospital’s compliance, quality, and revenue. To learn more, register now to secure your seat at the table during the next live edition of Talk ...
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  How Does Your Physician Advisor Measure Up? 16.06.2026 26мин

  Nearly every American hospital has at least one physician advisor. So, how does the physician advisor at your facility measure up? We reached out to longtime physician advisor Dr. Juliet Ugarte Hopkins to address this issue in her capacity as the special guest for the upcoming live edition of the popular Talk Ten Tuesday broadcast. According to Dr. Ugarte Hopkins, also the chief medical officer for Phoenix Medical Management, “physician advisors should be involved in far more (activities) t...
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  The New Battle in the Era of AI 09.06.2026 27мин

  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 losses are unforgiving. It’s the battle of algorithms. Employed by both payers and providers, the ultimate prize: money, in the form of reimbursement from submitted claims for medical care. Payers deny and recoup. Providers bill as margins shrink. During the next live edition of the ever-popular Talk Ten Tuesdays broadcast, senior healthcare analyst Frank C...
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  Artificial Intelligence: The Good, The Bad, and The Ugly 02.06.2026 30мин

  Although one could conclude that artificial intelligence (AI) is a relatively new technology in healthcare, the reality is that AI has been silently working in the shadows for a while now. During the next live edition of the popular Talk Ten Tuesdays broadcast, you’ll hear how AI is guiding the technology of the automated query technology at HITEKS, under the supervision of Gerasimos Petratos, founder and CEO. And what about the thousands and thousands of healthcare coders? Although AI is cha...
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  Healthcare Technology Demystified: The Series Begins 19.05.2026 32мин

  At last, the secrets of healthcare technology will be revealed during a fresh new two-part series, especially written for the accomplished healthcare professional who wants a refresher course on the latest developments that are quickly enveloping healthcare. Coders, clinical documentation integrity specialists (CDISs), and Revenue Cycle professionals who comprise the Talk Ten Tuesday (TTT) audience and who live inside the chart and the queue, are expected to benefit from an eye level rather t...
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  Help! Too Many Hats, not Enough Heads! 12.05.2026 27мин

  The role of physician advisor began as a friendly clinical champion for case/utilization management and clinical documentation integrity (CDI) teams. Today, the role has evolved into a catchall profession within hospitals. With a scope that encompasses multiple departments within revenue cycle, quality, and hospital utilization, it has becoming increasingly difficult for single individuals to successfully engage with and meet the needs of these groups. Enter the concept of...
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  ACDIS-AHIMA Proposed Practice Brief: Comment Period Now Open 05.05.2026 31мин

  What’s new for the proposed 2026 American Health Information Management Association/Association of Clinical Documentation Integrity Specialists (AHIMA-ACDIS) Practice Brief? What’s unchanged? And what does it really mean to issue a “compliant” query in today’s healthcare landscape? According to healthcare attorney Richelle Martin, the special guest for the next live edition of the popular Internet broadcast Talk Ten Tuesday, there’s plenty to talk about. The 2026 draft practice brief hits all...
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  Learn Something New: How Payer Logs can be a UR Resource 28.04.2026 31мин

  Learning how daily payer logs can help you and your utilization review (UR) team identify denials earlier, strengthen communication between UR and clinical documentation integrity (CDI), and improve the defensibility of medical necessity carries the potential to be a game-changer for healthcare professionals. During the next episode of Talk Ten Tuesday, Teri Rice, a regulatory specialist with HCPro, will highlight actionable strategies to reduce your facility’s risk and improve outcomes. The ...
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  LIVE from ACDIS, James S. Kennedy MD: Analysis of the 2027 IPPS Proposed Rule 21.04.2026 32мин

  The Association of Clinical Documentation Integrity Specialists (ACDIS) will conclude the formal agenda of its Annual Conference at the close of business next Tuesday in Chicago, but not before the preeminent Dr. James S. Kennedy reports on the highlights of the 2027 Inpatient Prospective Payment System (IPPS) Proposed Rule. Kennedy, no stranger to the Talk Ten Tuesday audience, will be the special guest during the next live edition of the popular Internet radio broadcast produced by ICD10mon...