by Denise Wilson, RN, MS, RRT, and Karla Hiravi, RN, BSN
Facility appeal writers must craft piles of appeals, with virtually no time to investigate the accuracy of payer denials. However, understanding the appeal process is crucial.Read More »
By Trey La Charité, MD, FACP, SFHM, CCDS
Over the years, Congress passed numerous pieces of legislation to limit healthcare spending, combat losses due to fraud, and ensure that dollars spent truly benefit the American population with quality care. Numerous watchdog programs...Read More »
Q:We are receiving denials on the grounds that encephalopathy must be resolved prior to discharge in order to be present. How would you suggest we fight these denials?Read More »
by Denise Wilson, RN, MS, RRT, and Karla Hiravi, RN, BSN
Acute kidney injury (AKI) is a sudden and temporary loss of kidney function, while acute tubular necrosis (ATN) is kidney injury characterized by acute tubular cell injury and dysfunction. CDI professionals need to...Read More »
Recently, the American College of Emergency Physicians (ACEP) and the Medical Association of Georgia (MAG) came out swinging against an insurer, Anthem. The pair of associations filed lawsuit against Anthem for its recently-implemented policy of denying medical...Read More »
Last week, the AHA submitted four, non-deadline related remedies to reduce the backlog of Medicare billing appeals awaiting adjudication at the ALJ level in response to a federal judge’s request...Read More »
