Talk Ten Tuesdays

Anyone who has been working within the scope of hospital case/utilization management for any period of time has heard of the Centers for Medicare and Medicaid Services (CMS) Conditions of Participation.

But are you familiar with the CMS Conditions for Coverage?  Sometimes referred to as “conditions of payment,” these requirements must be met in order for federal health plans to pay a healthcare facility for a submitted claim.

Welcome to the live edition of Talk Ten Tuesday, Dec. 9, 10 Eastern. That’s when Dr. Juliet Ugarte Hopkins, Chief Medical Officer for Phoenix Medical Management, Inc., will explain how failure to meet some aspects of the CoPs doesn’t mean there is a failure in Conditions for Coverage (CfC).

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

• Social Determinants of Health: Tiffany Ferguson, CEO for the aforementioned Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.

They were once called “clinical documentation improvement” specialists, charged with correcting the medical record to identify an overlooked diagnosis that carried the potential to increase revenue. Later, the description was changed to clinical documentation “integrity” (CDI) specialists. 

But that was then. This is now.

Today, the job description continues to change. CDI professionals are being asked to take on more and more responsibilities.

And that is why the producers of Talk Ten Tuesday have invited Penny Jefferson, a longtime CDI professional, to be the special guest during the next live edition of the weekly Internet broadcast.

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

·      Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.

·      CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest CDI updates.

·      The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.

·      News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

·      MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.

Since 80 percent of a person’s health is influenced by factors outside of medical care, it is critical that a healthcare system has an understanding and appreciation for the circumstances of patients’ daily lives that impact their health outcomes, referred to as the social determinants of health (SDoH). 

During the next live edition of Talk Ten Tuesday, Lauren Montwill, Vice President of Community Health and Social Impact for the UnitedHealth Group, will report on how her organization is collaborating on the delivery system to collect reliable SDoH data, as well as the effort to build health analytics infrastructure to benchmark, monitor, and track progress toward improving health outcomes and quality measures.

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

Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.

CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.

The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.

News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.

It’s often said that “words matter.”

And hospital patient status assignment is no exception. 

What do your teams say when a patient is in inpatient status which isn’t supported?  How about the reverse: when a patient is in outpatient status with observation services. Can your team change to inpatient? 

Words matter, and Dr. Juliet Ugarte Hopkins, chief medical officer for Phoenix Medical Management, Inc., will explain precisely how impactful your choices can be.

During the next live edition of Talk Ten Tuesday, Dr. Juliet Ugarte Hopkins will report on this timely topic.

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

• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

A new version of the Sequential Organ Failure Assessment (SOFA) score, has been introduced.

The new revision aligns the organ dysfunction measurement in critically ill adults with current clinical practices, especially those diagnosed with sepsis.

Published Oct. 29 in Journal of the American Medical Association (JAMA) and is available here https://jamanetwork.com/journals/jama/fullarticle/2840822.

During the next live edition of Talk Ten Tuesday, Dr. James S. Kennedy will discuss this new SOFA-2 revision and its expected impact on clinical validation for sepsis – defined by Sepsis-3 as a life-threatening organ dysfunction caused by a dysregulated host response to infection – and how facility clinical workflows can negotiate denial avoidance with payers with this challenging diagnosis.

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

• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest CDI updates.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the broadcast. Comfort is the Assistant Vice President of Revenue Integrity for Montefiore Health.

Welcome to “Is Ambient Listening Right for You?” Or, in the alternative, “Free AI Tools and Other Expensive Mistakes.”

Nick van Terheyden, MD, the special guest during the next live edition of Talk Ten Tuesdays, says he has seen enough of artificial intelligence (AI) “helpers” turn doctors into unpaid editors and part-time exorcists for hallucinating software.

“Clinicians signed up to heal humans, not debug bots,” Dr. Nick said. “Yet here we are, creating ‘AI slop’ so thick it needs its own billing code.”

Dr. Nick also references a Harvard study that says your coworkers think using AI makes you less competent; meanwhile, MIT says you’re probably not getting a dime’s worth of value. But don’t worry, you’re getting your AI tool for free! Which, like the “free drinks” at an all-inclusive resort, often tastes mostly like disappointment.

Finally, Dr. Nick offers this parting shot: “Remember: your medical records can’t be ‘vibe-coded’ clean. And while lawyers blame the AI for their made-up filings, you don’t get that luxury. Choose your AI tool wisely, because ‘no hallucinations added’ shouldn’t have to be in your note.”

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

• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest CDI updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

H.R. 1, known as the One Big Beautiful Bill Act (OBBBA), is set to reshape hospital finances by cutting an estimated $840 billion from Medicaid and Patient Protection and Affordable Care Act (PPACA) funding. As hospitals absorb these losses, many are tightening budgets, reducing staff, and facing renewed labor tensions.

For the first time, clinical documentation integrity (CDI) teams are part of this unionized landscape, connecting frontline workforce issues directly to reimbursement and data accuracy. When strikes or slowdowns occur, they can disrupt queries, coding, and claims, creating both financial and compliance risks. Together, these forces reveal how economic and workforce realities are now intertwined across every level of healthcare.

Reporting the lead story during the next live edition of Talk Ten Tuesdays, the popular Internet broadcast produced by ICD10monitor, will be Penny Jefferson, CDI Manager for UC Davis Health.

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

• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest CDI updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

Have you been told that Medicare and Medicare Advantage (MA) patients who have difficulties with activities of daily living (ADLs) are appropriate for inpatient status if their hospital stay crosses a second midnight? 

What direction have you received about “discharge effectuation?” 

Are your physicians keen on placing the majority of their patients into inpatient status because they want to prevent delivery of an expensive hospital bill? 

During the next live edition of Talk Ten Tuesdays, Dr. Juliet Ugarte Hopkins, the Chief Medical Officer for Phoenix Medical Management, will report on issues that have captured her interest as she discusses these, and other hot topics of misdirection and misinformation often encountered in the healthcare landscape.

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

• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

Join us this coming Tuesday, Oct. 14, when Talk Ten Tuesday will bring you an exclusive interview with two nationally recognized healthcare leaders: Thea Campbell and Mackenzie Higgins. Thea Campbell is the 2026 AHIMA President-Elect and Mackenzie Higgins is the 2025 AHIMA Emerging Star award recipient.

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

• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.
• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.
• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.
• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.

The revenue cycle helps keep hospital revenue flowing. But sometimes, it seems to sputter out, as if not all the cylinders are firing. And that is why the producers of Talk Ten Tuesdays have invited longtime ICD10monitor editorial consultant Dennis Jones, senior director of revenue cycle at the famed Jefferson Health, to be the special guest during the next live edition of the weekly Internet radio broadcast.

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

• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.

• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.

• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.

• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.