Auditors target multiple conditions which for clinical validation denials (CVD). Personally, I found acute kidney injury (AKI) and malnutrition the most commonly defensible targets. On the other hand, I often agreed with auditors on their CVDs...Read More »
Clinical validation denials (CVD) result from a review by a clinician, such as a registered nurse, contractor medical director, or therapist, who concludes, retrospectively, that a patient was not really afflicted by a condition documented in...Read More »
Editor’s note: Over the coming weeks leading up to the conference, we’ll take some time to introduce members to a few of this year’s speakers. The conference takes place May 9-12, at the MGM Grand in Las Vegas, Nevada. For today’s Q&A, we caught up with ...Read More »
CMS and representatives of the private insurance industry have agreed to use a single set of healthcare quality measures, according to a statement published by CMS.Read More »
We’re officially less than 100 days until the annual ACDIS Conference. As you begin to plan your itinerary, we’ll be posting regular updates to keep you in the loop on speakers, sessions, special events, and more.Read More »
Even though Promise Hospital of Ascension, a 54-bed transitional care hospital located in Gonzales, Louisiana, closed before the Office of the Inspector General (OIG) began auditing it for fraudulent Kwashiorkor claims, the agency found errors resulting in more than $450,000 in overpayments. In...Read More »
