Q: I encountered clinical validation issues where documentation noted a diagnosis with criteria, but the criteria used didn't meet the definition. For example, noted sepsis with criteria of tachycardia and increased white blood cell (WBC) count. But, the patient’s heart rate (HR...Read More »
In 2016, ACDIS’ members top three challenges were physician engagement, physician education, and pushback against CDI efforts from physicians. Respondents to an ACDIS membership survey at the time listed staffing retention and recruitment as their next two priorities.
In 2004, TV talk-show host Oprah Winfrey gave brand-new Pontiacs to every person in her nearly 300-member studio audience. It was a marketing ploy— she’d filled the audience with folks who needed cars. Desperately. The remembered refrain from that episode: “...Read More »
CMS recently updated its Recovery Audit program webpages with names of each new contractor, respective regions of responsibility, with links for updates, program reports, provider resources, and historical programs, according to Valerie A. Rinkle, MPA, a lead regulatory specialist and instructor...Read More »
CDI professionals recognize the effect comprehensive CDI programs have on both payment and profiling outcomes in all healthcare settings. As a result, many organizations are forging ahead to apply CDI beyond the walls of the traditional acute care...Read More »
HCPro is currently seeking speakers to present at the 2017 Revenue Integrity Symposium (RIS), to be held October 21–22, 2017, in Nashville, Tennessee. RIS seeks presentations on all aspects of revenue integrity, Medicare compliance, case management, and the revenue cycle, including...Read More »
Ochsner began its ambulatory clinical documentation excellence journey in 2004, when Medicare implemented its HCCs. Since HCCs affect patients’ Risk Adjustment Factor scores, and ultimately reimbursement for the care required to treat sicker patients, Ochsner needed to determine the best way to...Read More »
