Program Description

For Health Information teams, RCD readiness is about strengthening documentation integrity, improving clinical‑coding alignment and reducing preventable denials. This session provides a clear, practical framework for ensuring documentation supports medical necessity, meets CMS expectations and flows cleanly through the review pathways. This Medicare initiative applies to specific service types - most notably Inpatient Rehabilitation Facilities (IRFs) and Home Health Agencies - depending on the state and phase of rollout. The program also allows participating organizations to choose how their Medicare Fee‑for‑Service claims are reviewed – either pre-claim submission or post-payment.

Attendees will learn how to standardize processes, identify documentation gaps and implement proactive quality checks that protect reimbursement and streamline HI workflows. With a focus on accuracy, compliance and operational efficiency, this training equips HI professionals with the tools to confidently lead their organizations through the Review Choice Demonstration implementation. Attend this session to position your organization ahead of the curve and ensure your teams are ready for this new era of Medicare oversight.

Learning Objectives

• Explain the purpose and structure of the Review Choice Demonstration, including CMS’s goals, participating provider types, and the regulatory framework driving the program.
• Differentiate between the available review pathway options (pre‑claim review, post‑payment review, and other state‑specific choices) and identify the operational implications of each.
• Describe CMS’s compliance thresholds and affirmation requirements, including how agencies or facilities qualify for reduced oversight.
• Identify the documentation elements most frequently scrutinized under RCD and recognize common causes of non‑affirmation or denial.
• Assess the workflow, staffing, and process changes needed to successfully implement RCD within their organization.
• Apply best practices for preparing and submitting compliant claims, including strategies for documentation readiness, internal auditing, and communication with clinical teams. 

Presenter

Jose Talavera, RHIA
HIM Director, Casa Colina Hospital

Jose Talavera, MSHI, RHIA - Currently, the HIM Director at Casa Colina Hospital in Pomona, CA. I have worked at Casa Colina for 10 years now as the Director of Health Information Management Services and have  20+ years of experience in healthcare. Over the past years, I've acquired my national certification as a Registered Health Information Administrator (RHIA) through AHIMA and have a bachelor's in healthcare administration with a minor in informatics. This past year I received my master's in healthcare informatics from the University of San Diego.  With experience serving on a variety of boards, practice counsels, and advisor committees, I have contributed to the strategic direction and governance of numerous organizations.  My roles have included, President and Past President for IAHIA, Privacy and Security Practice Council member for AHIMA and Advisory Committee with Loma Linda University, where I have utilized my expertise as a health information professional and to drive impactful initiatives and foster organizational growth.

Continuing Education
CEUs: .50 (1/2)  |   HIIM Domain: Evolving Topics/Other HIIM Relevant Topics
This webinar has been approved for continuing education units (CEUs) to fulfill the continuing education requirements of AHIMA, AAPC, and ACDIS for CDI-related events not to exceed ten units from any single event. CEUs are based on contact hours. Thirty minutes of attendance at an educational program equals .5 CEU. For full details on AHIMA’s CEU qualifications, calculations, and more, view the AHIMA Recertification Website. CEUs may be adjusted based on the actual time of the event.  

Registration Fee

Community Webinar Rates

CHIA Members: Complimentary

AHIMA Members: $10

Non-Members: $15