You have requested access to content created exclusively for the ACDIS Leadership Council.
Member Insight: CDI professionals key to the clinical validation denials process
by Shirlivia M. Parker, MHA, RHIA, CDIP, BS-HIM
There have been a multitude of discussions in the CDI profession about denials, specifically clinical validations for the past several years. The question that one may ponder is why CDI isn’t leading the way of clinical validation denials. The answer to that may be understanding how we can fit in, who we should talk to, why we aren’t invited to participate. I think the answer to that question is understanding how clinical validation denials, work, and understanding that not everyone in the revenue cycle may know that these types of denials exist. This article will help you identify:
- Why the revenue cycle, specifically, the patient financial services (PFS) team may not know about these types of denials.
- How to establish yourself, as a CDI professional or unit in the process, lead the way to process improvement, and become that extension with PFS to win the race on clinical validation denials.
- Establish a tracking system to involve contracting and fight against strategies of the payers to take back money received, and your organization deserves.
- Understand the type of denials to help understand the overall process of establishing a denial program. We all need to be on the same page in understanding different types of denials.
This is an excerpt from content created exclusively for the ACDIS Leadership Council. If you’re a Council member, please log in to access the full post. If you’re not a Council member, please visit https://acdis.org/acdis-leadership-council to learn more about the Council, how to apply if you're a current CDI leader, and how to take advantage of the Council resources developed for the broader ACDIS community.
Please Log InForgot username or password?
Not an ACDIS member? Let's fix that!
ACDIS is the nation's only association dedicated to the clinical documentation improvement profession. Whether you're a veteran CDI specialist or new to the position, or a physician advisor or HIM/coding professional, you'll want to take advantage of all the benefits of ACDIS membership including a career center, CDI Journal, CDI Forum, sample forms and tools, and much more.
For questions and support, please call ACDIS customer service: 800-650-6787.