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Monitor Mondays

RACmonitor
Medicare
False Claims Act
Artificial Intelligence
Medicare Advantage
Racmonitor
Healthcare Compliance
Healthcare Auditing
Covid-19
Whistleblowing
Centers For Medicare & Medicaid Services
Mary Inman
Whistleblower Lawsuit
Medlearn Media Resource Center
Healthcare Regulations
R1 Physician Advisory Solutions
Physician Advisors Conference
Healthcare Audits
Non-Compete Agreements
Peer-To-Peer Discussions
Healthcare Technology

Join Chuck Buck every Monday when he welcomes RACmonitor contributing editors and special guests for the latest regulatory audit news and information from CMS, OIG and OMHA. And gain valuable context and perspective that can only be found when you’re listening to the long-running and popular Monitor Mondays. Register to attend live here: racmonitor.medlearn.com/racmonitor/podcasts/

PublishesWeeklyEpisodes394Founded8 years ago
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Artwork for Monitor Mondays

Latest Episodes

Artificial intelligence (AI) is becoming part of how clinical documentation is reviewed across healthcare, from coding and clinical validation to payer denials and appeals. 

In many cases, AI is influencing decisions behind the scenes, even when it ... more

Aetna is just the latest in a long list of healthcare entities to settle False Claims Act (FCA) allegations with a massive settlement.

The insurer, one of the nation’s largest, recently agreed to pay $117.7 million to resolve a case involving purpor... more

Imagine machine learning and natural language processing deployed to audit claims.

Today, it’s the new reality.

Autonomous coding is dramatically altering the treacherous auditing landscape. So, how can you protect your facility from takebacks?

How... more

Healthcare documentation is no longer written for a single audience. Today, the medical record must simultaneously meet federal regulatory requirements and the coverage expectations of individual payers.

While these systems often overlap, they origi... more

The Centers for Medicare & Medicaid Services (CMS) has launched a new initiative titled Comprehensive Regulations to Uncover Suspicious Healthcare (CRUSH).

CRUSH is a sweeping fraud prevention program. In an official news release posted Thursday, CM... more

Prior authorizations among Medicare Advantage plans have drawn criticism and concern from patients, providers, lawmakers, and regulators. But hospitals and doctors are uniquely positioned to advocate for their patients’ access to and coverage for car... more

In a January 28 article, Dr. Ronald Hirsch verified that the Centers for Medicare and Medicaid Services (CMS) “has no problem” with the Aetna Severity Payment policy because it “meets the Two-Midnight Rule.” 

However, there is more to consider than ... more

It’s raining RACs.

The Recovery Auditor Contractors (RACs), together with an alphabet soup of other private and public auditors, are coming down hard on hospitals and physician practices, looking for omissions and errors in submitted claims.

Then t... more

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Recent Guests

Frank Cohen
Senior Health Care Analyst
RAC Monitor
Episode: Autonomous Coding: A New Reality
Ronald Hirsch
MD, health care professional delivering Monday rounds
R1 Physician Advisory Solutions (sponsor)
Episode: CMS Launches CRUSH: A New Anti-Fraud Program
Penny Jefferson
Senior health care consultant discussing CRUSH impacts
UC Davis Medical Center (as described in the episode)
Episode: CMS Launches CRUSH: A New Anti-Fraud Program
Mary Inman
Famed whistleblower attorney
Whistleblower Partners
Episode: The Feds Blow the Whistle: A $45 Million Wound Care Settlement
Dr. James S. Kennedy
President of CDI, MD
Episode: New Sepsis Definition Could Help You Achieve Denial Avoidance
Sharon Easterling
Senior Healthcare Consultant
Episode: Audit Alert: Who’s Auditing AI?
Nicole Emanuel
Healthcare Attorney
Nelson Mullins Law Firm
Episode: Audit Alert: Who’s Auditing AI?
David Glaser
Healthcare Attorney
Fredrikson & Byron Law Firm
Episode: Audit Alert: Who’s Auditing AI?
Cate Brantley
Senior Health Care Legislative Affairs Analyst
Zelis
Episode: Audit Alert: Who’s Auditing AI?

Host

Chuck Buck
Host and Publisher of RAC Monitor, providing insights on regulatory news and information related to healthcare audits.

Top Education Podcasts

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Makes Sense - with Dr. JC DoornickDr. JC Doornick "The Dragon"
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Talking Points

Recent interactions between the hosts and their guests.

Medicare Advantage and Prior Authorizations: The Good. The Bad. The Ugly.
Q: Under the two midnight rule, would you consider the blood pressure check as simply the normal triage process or count it?
The consensus indicated that the blood pressure check prior to midnight does start the two midnight clock.
Reign of Terror: Special Audit Report
Q: What should nurses do in a situation where they suspect patient injuries inflicted by ICE agents?
Nurses should consider the legal responsibilities around reporting such injuries, taking into account confidentiality and state laws regarding abuse reporting.
Docs Take Another Financial Hit
Q: Do you think it's harder to win at the ALJ level than it was five or ten years ago?
Yes, particularly because ALJs are now more likely to have their decisions reversed by the MAC.
Docs Take Another Financial Hit
Q: Last time telehealth was paid retroactively, can we assume that that will happen again or do we know?
Yes, we may expect that.
Providers Appear More Aggressive in Defending Revenue
Q: What do you think about the inaccurate report from the OIG regarding outpatient hospital stays?
David has been assisting a client on an OIG audit, and he highlighted the critical misunderstanding regarding outpatient hospital stays under Medicare rules, emphasizing that it is not permissible to have extended outpatient stays.

Audience Metrics

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Frequently Asked Questions About Monitor Mondays

What is Monitor Mondays about and what kind of topics does it cover?

Focuses on regulatory audit news and updates affecting the healthcare industry, particularly revolving around Medicare and Medicaid. Regularly features insights from healthcare attorneys, healthcare executives, and legislative analysts who contribute to discussions on compliance, audit processes, and legislative updates that impact providers and patients alike. The podcast also highlights major settlements and prevalent issues in healthcare billing and coding, offering practical advice for navigating the complexities of healthcare regulations.

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Which podcasts are similar to Monitor Mondays?

These podcasts share a similar audience with Monitor Mondays:

1. Talk Ten Tuesdays
2. Becker’s Healthcare Podcast
3. The ACDIS Podcast
4. BiggerPockets Real Estate Podcast
5. WSJ Opinion: Potomac Watch

How many episodes of Monitor Mondays are there?

Monitor Mondays launched 8 years ago and published 394 episodes to date. You can find more information about this podcast including rankings, audience demographics and engagement in our podcast database.

How do I contact Monitor Mondays?

Our systems regularly scour the web to find email addresses and social media links for this podcast. We scanned the web and collated all of the contact information that we could find in our podcast database. But in the unlikely event that you can't find what you're looking for, our concierge service lets you request our research team to source better contacts for you.

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What guests have appeared on Monitor Mondays?

Recent guests on Monitor Mondays include:

1. Frank Cohen
2. Ronald Hirsch
3. Penny Jefferson
4. Mary Inman
5. Dr. James S. Kennedy
6. Sharon Easterling
7. Nicole Emanuel
8. David Glaser

To view more recent guests and their details, simply upgrade your Rephonic account. You'll also get access to a typical guest profile to help you decide if the show is worth pitching.

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