We’re considering doing a chart audit of our neonatal intensive care unit (NICU) but aren’t sure what the value of that would be. Do you have experience auditing your NICU charts? If so, what did you find?Read More »
Denials management and the appeals process has been on the rise as a popular CDI expansion area for years. As more and more CDI departments venture into this area, they need data to help them benchmark their progress and denial rates over time.
That’s where ACDIS’ latest polling question...Read More »
Anthem is currently facing a False Claims Act lawsuit from the Department of Justice (DOJ) for submitting inaccurate diagnosis codes to get a higher Medicare...Read More »
Risk adjustment primarily uses diagnosis codes related to chronic diseases to heighten reimbursement for sicker patients. CDI staff need to capture the documentation of these conditions annually to contribute to a patient’s risk score. They must be documented consistently throughout the medical...Read More »
Q: We’re having some trouble with malnutrition documentation. In many instances, the patient meets the American Society for Parenteral and Enteral Nutrition (ASPEN) criteria and the provider agrees with the query, but then doesn’t expand on the diagnosis in their documentation. We’re then...Read More »
According to an audit from the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG), a 253-bed hospital in Topeka, Kansas, received millions in overpayments because of incorrectly billing Medicare.
The OIG audit report states that Saint Francis Health Center...Read More »
With the launch of the CMS AI Health Outcomes Challenge, healthcare facilities should expect to see investigations on artificial intelligence being used for auditing. CMS says the AI Health Outcomes Challenge is an “opportunity for innovators to demonstrate how AI tools […] can be used to...Read More »
