This interactive session is conducted by an associate attorney whose work focuses on appeal of claims that have been denied by CMS contractors. She will discuss best practices for CDI specialist participation in denial management, and present actual...
While many facilities have developed robust denial management teams and have implemented comprehensive procedures for submitting appeals, one of...Read More »
Sarah C. Mendiola, Esq., LPN, CPC, presents actual examples of costly denials that could have been prevented with CDIS intervention. These include 2-midnight rule denials, medical necessity for major joint replacement (as outlined by CMS), and justification of MCCs that are difficult to support...
Kathy Shumpert, MSN, RN, CCDS, explores how CDI can have a positive impact on RAC and other auditor denials and explains how to integrate your CDI program with revenue recoupment strategies in a true documentation integrity model. This session includes case studies with examples of RAC denials...
Attached is the PowerPoint presentation “Successful Strategies to Avoid RAC Denials and DRG Downgrades”, by Adelaide M. La Rosa, RN, BSN, CCDS, AHIMA-Approved ICD-10-CM/PCS Trainer/Ambassador, project manager for quality operations...
While CDI and coding staff members are well versed in assigning a principal diagnosis, they are often less adept at incorporating the concept of...Read More »
