News: OIG audit says Tufts received $3.7 million in overpayments for high-risk diagnosis codes

February 24, 2022
CDI Strategies - Volume 16, Issue 8
Denials & Appeals, Clinical & Coding

An audit performed by the Office of Inspector General (OIG) of Tufts Health Plan,...Read More »

News: OIG to audit for malnutrition

February 24, 2022
CDI Strategies - Volume 16, Issue 8
Denials & Appeals, Clinical & Coding, News

The Health and Human Services (HHS) Office of Inspector General (OIG) has...Read More »

Note from the ACDIS Director: OIG announces audits of Medicaid inpatient hospital claims for severe malnutrition; ACDIS wants to hear about your experiences

December 16, 2021
CDI Strategies - Volume 15, Issue 55
Denials & Appeals, Quality & Regulatory

by Brian Murphy

For the last few years, ACDIS has been working with a multiorganizational malnutrition diagnosis, documentation,...Read More »

2021 Day 1 Track 4: Clinical Validation and the Denial Defense

December 14, 2021
Conference Materials
Denials & Appeals

Clinical Validation and the Denial Defense
Kimberly Huff, BA, COC, CCDS, Clinical Validation Denials Coordinator at Providence Ministry, in northern California
When it comes to denials, unfortunately, the CDI team needs to ensure the...

Journal excerpt: Leveraging templates, building successful appeals

November 23, 2021
CDI Blog - Volume 14, Issue 51
Denials & Appeals

Aside from a defense attorney mindset, there are additional processes that can improve your chances of winning an appeal and successfully...Read More »

News: Coventry Health Care received half a million dollars in overpayment, latest OIG audit finds

November 11, 2021
CDI Strategies - Volume 15, Issue 50
Denials & Appeals, News

In its latest round of Medicare Advantage audits, the...Read More »

Download the November/December 2021 edition of the CDI Journal!

November 1, 2021
CDI Journal - Volume 15, Issue 6
ACDIS Guidance, Denials & Appeals, Quality & Regulatory

FEATURES
​6 Submitting suggestions for the IPPS
...Read More »

Guest column: Sepsis and ARDS denial prevention

November 1, 2021
CDI Journal - Volume 15, Issue 6
Denials & Appeals, Clinical & Coding

by Alba Kuqi, MD, MSHIM, CDIP, CCS, CCDS, CRCR, CICA, CSMC, RHIA, CCM
Acute respiratory distress syndrome (ARDS) is an acute...Read More »

Submitting suggestions for the IPPS: Simplicity is key

November 1, 2021
CDI Journal - Volume 15, Issue 6
ACDIS Guidance, Denials & Appeals, Quality & Regulatory

by Carolyn Riel
The inpatient prospective payment system (IPPS) was first implemented in 1983 to help combat unnecessary or...Read More »

Case study: A courtroom approach to denials

November 1, 2021
CDI Journal - Volume 15, Issue 6
Denials & Appeals, Quality & Regulatory

by Carolyn Riel
CDI programs can take many approaches to manage denials, whether they focus on physician documentation education,...Read More »

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