Denials & Appeals

Q: How can we develop clear expectations for our denial management program?Read More »

Q: What sepsis criteria does CMS prefer people use? Do other insurance plans let you know which...Read More »

UnitedHealthcare announced recently that, starting January 1, 2019, they will use sepsis-3 criteria for validating sepsis claims.Read More »

It seems that there’s a new headline every day related to denials and audits. Not much has changed when it comes to the content of those...Read More »

Q: Is it a best practice for a hospital to get a consensus within their own facility to use one...Read More »

Like a well-oiled machine, each component—or revenue cycle department—must function optimally to perform at its peak. Therefore, denial avoidance...Read More »

by James P. Fee, MD, CCS, CCDS, AHIMA-approved ICD-10-CM/PCS trainer

CDI physician advisors use their clinical experience linked...Read More »

Denial management is traditionally focused on improving hospital revenue cycle and financial performance. Appropriate routing and handling of...Read More »

Whether it be medical necessity, clinical validation, or coding-related—denials seem always...Read More »

ACDIS added a new category to the Forum to give members the place to discuss questions...Read More »