by James S. Kennedy, MD, CCS, CDIP, CCDS
Many hospitals find that their patient safety indicator (PSI) ratios remain high despite doing a spectacular job of addressing these events and exclusions.Read More »
Physicians are ethically engaged in keeping patients safe and doing no harm. Unfortunately, medical and surgical care is complicated, especially in patients with high-risk comorbidities; thus, unintended negative results do occur.Read More »
Be aware of payer’s “home cooked” clinical criteria which are often not only outdated, but also ridiculous. Contrary to what the payer may claim, a patient does not regularly have to be at a near death state before having achieved grounds...Read More »
Generally speaking, developing consistent query policies and procedures for both coding and CDI staff helps keep everyone in compliance with coding regulations. Similarly, work with clinicians, CDI specialists, and coders as often as...Read More »
By Laurie L. Prescott, MSN, RN, CCDS, CDIP, CRC, and Sharme Brodie, RN, CCDS
The goal of the risk-adjustment model applied to Medicare Advantage plans is for Medicare to provide more accurate payments to the plan administrators to compensate for the care provided.Read More »
