For many third-party Medicare auditors, the only rules they follow are their own, substituting personal preference for regulatory realities – and all in the name of claim denials. Every day in nearly every American hospital, health system, or physician practice, some dedicated healthcare professional asks, “how could they do this to us?”

There is a rightful place for Medicare auditing. But too often, in too many instances, legitimate auditing takes a backseat to the arbitrary denial of claims. This week, during another live edition of Monitor Mondays, the most trusted subject-matter experts in healthcare regulation will come together to discuss the latest examples of auditing gone awry. And highlighting the role of the physician advisor, who often is asked to interpret regulations, will be Dr. Elizabeth Quinn, the National Physician Advisor Conference chair.

Other segments to be featured during the live broadcast include the following:

• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.
• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.
• RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.
• Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the status of healthcare legislation associated with the current COVID-19 pandemic.
• SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of healthcare regulations and the SDoH.