by Irina Zusman, RHIA, CCS, CCDS
Both ccommercial and public payers now deny about one in every 10 submitted claims, costing health...Read More »
Every year, organizations receive more denials, and payers’ tactics are shifting based on coding rules, clinical criteria, and their own whims....Read More »
For CDI professionals working on denials management or appeals in any capacity, the payer side of the equation can often seem mystifying. Recently...Read More »
According to the 2019 CDI Week Industry Survey, 27.77% of respondents who are currently involved in the denials management/ appeals process work...Read More »
by Sarah Nehring, CCS, CCDS
The last thing a query writer wants is to provoke a defensive response, but in the current healthcare...Read More »
On February 23, 2016, the Journal of the American Medical Association published new clinical definitions for sepsis and septic shock, dubbed “...Read More »
FEATURES9 CDI in a changing denials landscape13...Read More »
CMS proposes to extrapolate results from Medicare Advantage (MA) audits and apply an overall error rate for all plans, according to...Read More »
This sample level 2 appeal letter was provided by Jera Van Damme, BSN, RN, CCDS, senior clinical documentation educator at Essentia Health in Duluth, Minnesota.
This sample has been reviewed and approved by the Forms & Tools Library...
This sample appeal letter was provided by Jera Van Damme, BSN, RN, CCDS, senior clinical documentation educator at Essentia Health in Duluth, Minnesota.