Nowhere does work in the healthcare setting feel more like a courtroom than the denials arena. Hospitals and healthcare systems seek to provide the best quality of care to their patients, but that care can come grinding to a halt if an organization’s billing gets...Read More »
The process of denials and appeals is often referred to as a form of "word game" with players crafting persuasive arguments using specific language to present and counter claims. It’s important to recognize, however, that the stakes are
At this very moment, ACDIS is busy with final preparations for arguably our most exciting time of year! CDI Week 2023 will be held September 18–22, and this year’s theme is CDI Success Stories: Writing Your Next Chapter....Read More »
CDI departments have long been involved with the denials management process at this point, most frequently helping with clinical validation and DRG downgrade denials as those seemed to naturally fit into CDI’s regular preview. Medical necessity denials—i.e.,...Read More »
When I became a CDI specialist, I did not foresee myself being someone who would be writing clinical validation appeals. Historically, as a utilization review case manager, I generated medical necessity denials based on my chart review...Read More »
Presenting your authentic self is a key factor in reaching personal and organizational success. In CDI, we have great opportunities to promote authenticity on our teams. The ability to present your authentic and genuine self has many benefits,...Read More »