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 »
by Linnea Archibald
When people talk about CDI’s effect on an organization’s health, often they are referring to the traditional CC/MCC capture and DRG changes for financial improvement and accuracy associated with CDI reviews. Of course, we know that CDI professionals do so much...Read More »
by Carolyn Riel
CDI teams have to work with other departments nearly daily in their line of work, be it the coding department, the clinical team, the quality department, or others. When it comes to denials management, this interdepartmental collaboration becomes even more...Read More »
by Sydni Johnson, RN, BSN, CCDS, and Denice Piwowar, BSN, RN, CCDS
CDI professionals generally consider clinical validation queries to be the most challenging queries to generate and format. As CDI managers and educators, we’re often asked how to request supporting indicators of a...Read More »
by Melissa Varnavas
When I was a kid, my siblings would tease me. They’d tell me I was wrong, that I didn’t know what I was talking about. They’d say, “You’re in denial, and it ain’t just a river in Egypt.” Imagine a kid in pigtails sticking out her tongue and wagging her fingers...Read More »
by Linnea Archibald
As the CDI profession has matured and expanded over the years, many CDI departments find themselves pulled down new avenues outside of the traditional chart review process. While not traditionally a role of CDI work, many have begun branching out into denials...Read More »
by Anneleah Williams-Bridges, MS, MBCA, RHIA, CCS, CCS-P, CCDS, RH-CBS, LIA
Until recently, many organizations have solely used their CDI resources to strengthen the capture of CCs/MCCs, Hierarchical Condition Categories, severity of illness/risk of mortality, and DRG validation....Read More »
