Even though Promise Hospital of Ascension, a 54-bed transitional care hospital located in Gonzales, Louisiana, closed before the Office of the Inspector General (OIG) began auditing it for fraudulent Kwashiorkor claims, the agency found errors resulting in more than $450,000 in overpayments. In...Read More »
Ever make mud pies? A hose running rivers in the backyard sandbox or a collection of buckets and throwaway pie tins lining an oversized puddle after a rainstorm make the best kitchens for such non-culinary fun. How CDI managers must long for those moments when they needn’t worry about how each...Read More »
Outpatient coding and billing errors led to more than half of all automated denials by Recovery Auditors, according to the latest RACTrac survey from the American Hospital Association (AHA). Outpatient errors increased by 10% from its third quarter 2014 survey with the nationwide average...Read More »
The CDI profession often focuses on engaging providers and other medical staff members in documentation improvement efforts. However, CDI managers also need to examine productivity standards, accountability, and staff engagement. Assessing the quantity of staff reviews does not gauge whether a...Read More »
As local chapters begin 2016 meeting planning, many need your help. Specifically, Florida, Illinois, Central Pennsylvania, and Virginia are seeking core leadership teammates. To be a local chapter leader, volunteers should live or work within the geographic region for which they are volunteering...Read More »
A physician admits a patient with dementia, yet provides no further definitive diagnosis. The CDI specialist recognizes the scenario as similar to a case reviewed the week before, so she reaches out to the case management (CM) team to see whether they have additional insight. The CDI...Read More »
CMS continues to transition from volume-based to value-based payments and Alternative Payment Models (APM), including bundled payment models, with the goal to have 30% of its payments tied to APMs by 2016 and 50% by 2018. In 2011, CMS sought out providers to test four broadly defined bundled...Read More »
by Valerie Bica, BSN, RN
Providers often document “global devel dopmental delays” in pediatric charts. The phrase is used to describe when a child takes longer to reach certain development milestones than other children the same age, such as walking or talking. Children with...Read More »
