Denials & Appeals

A Medicare hospital provider compliance audit performed by the Office of Inspector...Read More »

by Shirlivia M. Parker, MHA, RHIA, CDIP, BS-HIM

There have been a multitude of discussions in the CDI profession about...Read More »

In a review of 100 claims, an OIG audit of Northwest...Read More »

The ACDIS Forms & Tools Committee works to review materials donated to the ACDIS...Read More »

More than $3 million could be owed by Anthem, according to an Office of...Read More »

It may seem logical, but clinical judgement—or mistakes thereof—represents a serious concern in relation to malpractice suits according to a CRICO...Read More »

Recently, we’ve seen an uptick in clinical validation denials regarding acute pulmonary insufficiency and acute respiratory failure following...Read More »

The Office of Inspector General (OIG) performed a provider compliance audit of...Read More »

An important step toward preventing malnutrition denials on the front end is...Read More »

Are institutions appealing sepsis denials if the patient meets sepsis-2/super systemic inflammatory response syndrome (SIRS) criteria, but not...Read More »