2017 Conference, Day 2, Track 4: Denials Management/Appeals: An ALJ's Perspective

May 23, 2017
Conference Materials
ACDIS Guidance, Denials & Appeals, Quality & Regulatory

Alicia Kutzer, BS, Esq. LLM

Hear from an Administrative Law Judge (ALJ) and former QIC employee who was integral in developing training materials and presentations for proper adjudication of Medicare appeals, and defended claim denials at the reconsideration and ALJ levels of...

Book Excerpt: Understanding basic types of denials

April 19, 2017
CDI Blog - Volume 10, Issue 49
ACDIS Guidance, CDI Expansion, Denials & Appeals

by Tanja Twist, MBA/HCM

You can’t manage what you don’t understand. So, the first step in any effective denials management program...Read More »

Conference Conversations: Brant offers insight into recovery auditor programs

April 6, 2017
CDI Blog - Volume 10, Issue 43
Ask ACDIS, Denials & Appeals, Quality & Regulatory

Editor’s Note: Over the coming weeks leading up to the conference, we’ll take some time to introduce members to a...Read More »

Book Excerpt: Review all charts to maintain a compliant CDI program

March 31, 2017
CDI Blog - Volume 10, Issue 41
ACDIS Guidance, Policies & Procedures, Denials & Appeals

If at all possible, CDI programs should review all hospitalizations in a facility for documentation improvement opportunities. And all charts...Read More »

Radio Recap: Brundage discusses denials and physicians communication

March 21, 2017
CDI Blog - Volume 10, Issue 34
Ask ACDIS, Education, Denials & Appeals

Editor’s Note: Timothy Brundage, MD, CCDS, medical director of Brundage Medical Group, LLC, in Redington Beach,...Read More »

Guest post: Querying for clinical validity

February 28, 2017
CDI Blog - Volume 10, Issue 23
ACDIS Guidance, Physician Queries, Denials & Appeals

by Erica E. Remer, MD, FACEP, CCDS

Some clinicians may interpret a query as an affront to their clinical judgment. This is not...Read More »

Guest Post: Clinical validation denial targets

February 22, 2017
CDI Blog - Volume 10, Issue 19
ACDIS Guidance, Denials & Appeals, Quality & Regulatory

by Erica E. Remer, MD, FACEP, CCDS

Auditors target multiple conditions which for clinical validation denials (CVD). Personally, I...Read More »

Guest Post: Protecting documentation from clinical validity denials

February 14, 2017
CDI Blog - Volume 10, Issue 16
ACDIS Guidance, Denials & Appeals, Quality & Regulatory

by Erica E. Remer, MD, FACEP, CCDS

Clinical validation denials (CVD) result from a review by a clinician, such as a registered...Read More »

Guest Post: Tips for new Recovery Audit program denial defense

February 7, 2017
CDI Blog - Volume 10, Issue 14
ACDIS Guidance, CDI Expansion, Denials & Appeals

By Laura Legg, RHIT, CCS, CDIP

...Read More »

Guest Post: Tips for appealing MS-DRG denials

January 3, 2017
CDI Blog - Volume 10, Issue 1
ACDIS Guidance, CDI Expansion, Denials & Appeals

by Sam Antonios, MD, FACP, FHM, CPE, CCDS

Over the last 18–24 months, health- care organizations have seen a surge in MS-DRG...Read More »

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