A number of inpatient prospective payment system changes in recent years, due primarily to the Affordable Care Act, have allowed CMS to adjust healthcare reimbursement based on quality metrics and data. But some providers are unaware that many quality scores for themselves and hospitals are...Read More »
Nearly 60% of patients say that online reviews matter to them when choosing a physician, according to a study conducted by the Journal of the American Medical Association (JAMA) in 2014. However, the scope and usefulness of those online reviews are limited, according to a study conducted by JAMA...Read More »
Mortality reviews are becoming more prevalent in the CDI world. But what do they really mean for CDI specialists? Some organizations have mortality review committees, but such reviews don’t always fall under CDI; they could be managed by the quality...Read More »
Q: According to a denial letter, acute metabolic encephalopathy secondary to any disease (which it obviously always is) codes to G94, other disorders of brain in diseases classified elsewhere. The auditor stated to “Please see code category G93.4 which has an excludes 1 note excluding “...Read More »
Every quarter since January 2014, the American Hospital Association (AHA) has collected and published survey data from its member facilities regarding government audit activities in its RACTrac surveys, reports, and related webinars. Although new Recovery Auditor contracts were awarded in...Read More »
Though I can now follow along with (at least some of) the acronyms related to CDI, I’m still pretty new to the field. Ever since I was eight years old—or so my parents tell me—I wanted to be a writer. So, when I saw the job posting and description for the...Read More »
Q: When looking at denials timelines, what information should be noted?
A: There are many critical time elements to capture during the denial appeals process. It is recommended that you add these to your denials database. If that is not possible, an...Read More »
