Alleged fraudulent billing schemes were charged against 36 defendants at an estimated $1.2 billion, according to Medscape Medical News. The fraud was tied to telemedicine, genetic and cardiovascular testing, and equipment,...Read More »
Not all CDI teams are directly involved in the denials management or appeals process, but every CDI professional knows the value of avoiding a denial in the first place. CDI departments employ many methods, often concurrently, to target different issues related to...Read More »
Recently, the Kaiser Family Foundation analyzed transparency data released by CMS on claims denials and appeals data reported in 2020 and released...Read More »
A recent audit conducted by the Office of Inspector General (OIG) projected that hospitals received $47.8 million in net overpayments from January 2018 through July 2019 for Medicare Part A claims that did not meet national...Read More »
ACDIS polls are a great way to get snapshots of data you can leverage to benchmark your own efforts, answer a pressing question, or identify an area of potential expansion or research. In many cases, the polls you see on our website homepage are submitted by...Read More »
The Health and Human Services (HHS) Office of Inspector General (OIG) has announced its plan to audit hospitals for severe malnutrition diagnosis codes on inpatient claims.
by Kathy Shumpert, MSN, RN, CCDS
I started my CDI career in 2008. As every new CDI professional knows, the first year is challenging. But I was not able to catch my breath the second year either, as we began to receive Recovery Audit Contractor (RAC) denials. By default, I had to...Read More »
