Possibly the greatest financial challenge healthcare organizations face day-to-day is the consistent influx of denied claims. According to a recent KFF...Read More »
Clinics, specialty groups, and ambulatory care centers are facing systemic strains from the outpatient healthcare infrastructure, according to the Outpatient Pressure Index...Read More »
The American Hospital Association (AHA) sent comments to the Medicare Payment Advisory Commission (MedPAC) ahead of their January meeting regarding payment update recommendations. Specifically, the AHA urged MedPAC to:
Recommend higher payment updates for inpatient and outpatient
UnitedHealth Group (UHG) used “aggressive strategies” to increase its Medicare Advantage (MA) risk adjustment scores and collect higher payments from MA enrollees’ diagnoses, according to a new Senate Judiciary...Read More »
In the world of CDI, we are no longer just fighting for clarity; we are fighting against an algorithm. As payers increasingly leverage artificial intelligence (AI) and natural language processing to conduct high-volume clinical...Read More »
Q: I primarily work in the neurosurgery review lane within CDI and am seeking further guidance on best practices for capturing loss of consciousness (LOC) status in cases of traumatic subdural or subarachnoid hemorrhage. Current definitions of LOC appear broad and can be challenging...Read More »
