ACDIS update: New ACDIS white paper on denials available now!

Insurance claim denials and DRG downgrades are frequent concerns and growing areas of focus for CDI programs. CDI functions have expanded to include denial mitigation in their record review process, seeking to capture patient complexity, clarify documentation inconsistencies, and clinically validate reported diagnoses.

A recent ACDIS CDI Leadership Council research survey noted that a few CDI management teams are becoming actively involved in managed care contract negotiations and building teams of second-level reviewers and providers who participate in the appeals process and collaborate within the revenue cycle.

Conversely, many organizations have not yet realized the full potential of their CDI team related to denials management efforts. As healthcare organizations continue to experience a multitude of financial stressors, organizations can only benefit from multidisciplinary collaboration in the management of denials and appeals processes.

In this spirit of collaboration, ACDIS has created a white paper, authored by members of the ACDIS Advisory Board, to explore the different denial types and CDI's impact in these areas. It is part of an ongoing planned series of white papers. 

Click here to view “Understanding denial types and CDI’s impact” now!