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Ronald Hirsch, MD, is the vice president of regulations and education of R1 Physician Advisory Solutions (PAS) at R1 RCM, Inc. Dr. Hirsch graduated medical school from Chicago Medical School in North Chicago, IL, and completed his internal medicine residency at Kaiser Permanente Medical Center in Hollywood, CA. Dr. Hirsch was medical director of case management at Sherman Hospital. He was also a general internist and HIV specialist at Signature Medical Associates, a multispecialty practice located in Elgin, IL, where he previously served as president.
Dr. Hirsch’s career in medicine includes many clinical leadership roles at healthcare organizations ranging from acute care hospitals and home health agencies to long-term care facilities and group medical practices. In addition to serving as a medical director of case management and medical necessity reviewer throughout his career, Dr. Hirsch has delivered numerous peer lectures on case management best practices and is a published author on the topic.
He is on the advisory board of the American College of Physician Advisors, the advisory board of the National Association of Healthcare Revenue Integrity, a member of the American Case Management Association and is a Fellow of the American College of Physicians. He is the co-author of the Hospital Guide to Contemporary Utilization Review, with the third edition published in 2021.
Areas of expertise
- Billing Compliance
- Case Management
- Charge Capture
- Coding Management and Compliance
- Contract Management
- Denials Management and Prevention
- Length of Stay
- Medicare Regulations and Reporting/PEPPER
- Patient Accounting
- Patient Experience
- Physician Advisory Solutions
- Utilization Review
Published work and resources
Dr. Hirsch is a distinguished contributor to several well-read healthcare publications, including RACmonitor and Becker’s Hospital Review. Through his published content, Dr. Hirsch imparts a wealth of knowledge and expertise to healthcare providers around the country.
RACmonitor is a vital news and information source for healthcare providers, offering timely insights and updates on regulatory compliance, reimbursement challenges and operational efficiency.
Becker’s Hospital Review is a leading source of news and analysis for healthcare decision-makers, delivering critical insights on industry trends, hospital management and policy changes.
This comprehensive resource designed to identify utilization review (UR) best practices and provide guidance on developing and enhancing a contemporary UR committee. This book focuses on the latest UR and patient status requirements to help hospitals perform high-quality reviews and comply with regulations in a value-based world.
Important reimbursement rate information based on CMS guidelines.
- Inpatient Only Lists: A compilation of procedures that Medicare will only reimburse when performed in an inpatient setting. 2023, 2024, 2025
- Addendum B: CMS list of all services. January 2025, October 2024
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