by Carolyn Riel
The inpatient prospective payment system (IPPS) was first implemented in 1983 to help combat unnecessary or excessive services being charged when Medicare was reimbursing on a fee-for-service model. Before the IPPS, the International Classification of Diseases (...Read More »
by Leyna Belcher, MSN, RN, CCDS, CCDS-O
According to Margaret Thatcher, “You may have to fight a battle more than once to win it.” In healthcare, the ultimate ongoing battle is fighting denials. These denials have become a battleground as payers lack oversight and are inconsistent...Read More »
by Carolyn Riel
CDI programs can take many approaches to manage denials, whether they focus on physician documentation education, have a team member dedicated to writing appeals, or anything in between. For Kimberly Huff, COC, CCDS, clinical validation denials...Read More »
by Carolyn Riel
All CDI professionals, whether new to the field or industry veterans, should be familiar with the American Hospital Association’s (AHA) Coding Clinic. “They are one of the leading authorities, and their advice is there to help us as CDI and coding...Read More »
by Brian Murphy
CDI has come a long way from the days of DRG optimization. Today’s healthcare landscape is far more interconnected than it was a decade ago. Capitated payment models, bundled episodes of care, and pay-for-performance are slowly but inexorably taking more of the pie...Read More »
by Linnea Archibald
In a healthcare environment that puts increasing emphasis on pay-for-quality models, it’s no surprise that nearly 92.5% of all respondents to the...Read More »
by Deanne Wilk, BSN, RN, CCDS, CDIP, CCDS-O, CCS
Patient safety and quality of care are forerunning concerns for organizations today. Not only do we want to ensure our patients are receiving high-quality care, we want to ensure care is safe and effective. We need to examine how...Read More »
Some of the largest hospitals in the country have approached the price transparency rule by providing some pricing information online, but not providing the healthcare common procedure coding system (HCPCS) codes for the services, according to a review of 20 hospital websites by...Read More »
