By now most CDI professionals have likely seen the July Office of Inspector General (OIG) audit report, which can be found here. If you haven’t, that...Read More »
The Office of Inspector General (OIG) will begin reviewing Medicare payments for COVID-19 discharges, according to a recent update to its ...Read More »
Did you know that nearly 41% of CDI departments are involved in the denials management or appeals process and nearly 40% of their denials come from private payers? Did you know that more than 80% of CDI professionals query, even when the query outcome only impacts a quality measure rather than...Read More »
The California Department of Managed Health Care (DMHC) has fined Aetna $500,000 for denying almost 93% of investigated emergency department (ED) claims. The fine is the result of Aetna wrongfully denying their members...Read More »
ACDIS is looking for folks to submit their ideas for the next, and last 2020 edition (November/December) of the CDI Journal. This edition is focused on denials management and appeals.Read More »
According to a status report, the United States Department of Health and Human Services (HHS) has reduced its backlog of Medicare appeals at the Administrative Law Judge level by 43% through...Read More »
Q: Our dietitians send cases needing a query for malnutrition to our CDI staff. Previously, they were notifying providers of the need for the documentation of the diagnosis directly, but from a compliance perspective, they were more comfortable with us owning the formal query...Read More »
