Talk Ten Tuesdays

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 records of Medicare Advantage patients when those codes were not indicated.

So, listen and learn when special guest Liz Soltan, counsel for Whistleblower Partners, will discuss the role of coders in these cases.

The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:

• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.

• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).

• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.

• The Coding Report: Christine Geiger will report on the latest coding news.

• Talk Ten Tuesday News Desk: Timothy Powell, will deliver the latest news from the Talk Ten Tuesday News Desk.

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 when special guest Dr. Juliet B. Urgarte Hopkins, chief medical officer for Phoenix Medical Management discusses the role of utilization managers.

The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:

• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.

• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).

• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.

• The Coding Report: Christine Geiger will report on the latest coding news.

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: Senior healthcare analyst Frank Cohen to reveal how when claims are viewed in isolation, there is a great likelihood of audits.

• POV: Penny Jefferson, cohost of Talk Ten Tuesdays, will share her point of view (POV) during the broadcast.

• The Coding Report: Chris Geiger, will report on the latest coding news.

• CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).

• SDoH Report: Tiffany Ferguson, the CEO for Phoenix Medical Management, will report on news that’s happening at the intersection of patient care and medical record coding.

Then, during the second half of the broadcast, we have invited a host of renowned guest panelists, including the following:

1. Edward Roche
2. Ronald Hirsch, MD
3. Matthew Albright
4. Maureen Testoni. Esq.
5. Denise Buenning
6. Fred Stodolak

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 learn during the next live edition of Talk Ten Tuesdays. That’s when special guest Veronica Richardson, senior compliance consultant at First Class Solutions, will discuss how HIM can play a significant role in behavioral health compliance.

The popular weekly Internet broadcast will also feature these additional instantly recognizable panelists, who will report more news during their segments:

• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.

• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).

• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.

• The Coding Report: Christine Geiger will report on the latest coding news.

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 subject-matter experts will also join the broadcast with more news to report, including the following:

• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.

• The Coding Report: Christine Geiger returns to Talk Ten Tuesdays to report on the latest coding news.

• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.

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 situation, and anticipated post-operative course.

Listen and learn during the next upcoming edition of Talk Ten Tuesdays, when Dr. Juliet Ugarte Hopkins will offer practical patient function concepts for supporting inpatient status in the absence of the IPO list.

Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:

• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).

• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.

• The Coding Report: Christine Geiger returns to Talk Ten Tuesdays to report on the latest coding news.

• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.

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-compliant” query and the problem with referring to certain query formats as “leading.”

If you have had claims denied by third-party payers for “non-compliant” queries or if you have wondered how your organization would respond to allegations of leading or non-compliant queries, you’ll want to listen to this remarkable broadcast.

What’s changed? And what does it really mean to issue a “compliant” query in today’s healthcare landscape?

Listen and learn.

Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:

• POV: Penny Jefferson, Manager of Coding & Clinical Documentation Integrity Services for the University of California-Davis Medical Center, will share her point of view during the broadcast.

• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).

• SDoH Report: Tiffany Ferguson will report on news happening at the intersection of compliance and medical record coding.

• The Coding Report: Christine Geiger returns to Talk Ten Tuesdays to report on the latest coding news.

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 Ten Tuesdays, coming up at 10 a.m. EST on Tuesday, June 23.

Other well-known subject-matter experts will also join the broadcast with more news to report, including the following: 

•Tech Report: Senior healthcare analyst Frank Cohen concludes the third installment in his three-part series on AI and coding.

•POV: Penny Jefferson, cohost of Talk Ten Tuesdays, will share her point of view (POV) during the broadcast.

•The Coding Report: Rose Dunn, who will substitute for Christine Geiger, will report on the latest coding news.

•CDI Report: Cheryl Ericson will provide an update on clinical documentation integrity (CDI).

•SDoH Report: Tiffany Ferguson, the CEO for Phoenix Medical Management, will report on news that’s happening at the intersection of patient care and medical record coding

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) than secondary status reviews and peer-to-peer calls.”

To learn more, register now to secure your seat at the table during the next live edition of Talk Ten Tuesday, coming up at 10 a.m. EST on Tuesday, June 16.

Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:

• Part II: Coding and AI Senior healthcare analyst Frank Cohen, continues with Part 2 in his three-part series on coding and artificial intelligence.

• POV: Penny Jefferson, cohost of Talk Ten Tuesdays, will share her point of view (POV) during the broadcast.

• The Coding Report: Deanna Peterson, who will substitute for Christine Geiger, will report on the latest coding news.

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 Cohen, himself a veteran of algorithmic warfare, will escort you behind the front lines and into war rooms, so that you will have a better understanding of what is contributing to rising medical costs. Cohen’s three-part article series on ICD10monitor.com begins this coming Tuesday.

Other well-known subject-matter experts will also join the broadcast with more news to report, including the following:

• POV: Penny Jefferson, cohost of Talk Ten Tuesday, will share her point of view (POV) during the broadcast.

• CDI Report: Cheryl Ericson will provide an update on all things clinical documentation integrity (CDI).

• The Coding Report: Christine Geiger will report on the latest coding news.