Policies & Procedures

TMF Health Quality Institute released a new Program for Evaluating Payment Patterns Electronic Report (PEPPER) for short-term acute care hospitals...Read More »

By Jackie Birmingham, RN, BSN, MS, CMAC

Editor’s note: For more information, see ...Read More »

By Jocelyn E. Murray, RN, CCDS

There’s no question of the financial sustenance facility case mix index (CMI) provides. An elevated...Read More »

Under the Affordable Care Act (ACA), providers have to recertify their Medicaid reimbursement eligibility. Because of this provision, more than 65...Read More »

Radiation oncology services billed to CMS had a 9.6% improper payment rate in 2015, leading to Medicare improperly pay $137 million for these...Read More »

by Joel Moorhead, MD, PhD, CPC
This article is about bringing the patient to the center of clinical validation. A patient with an “...Read More »

Septic patients can quickly deteriorate into severe sepsis cases if left unattended. “Once they have organ failure, it’s really hard to get those...Read More »

by Sam Antonios, MD, FACP, SFHM, CCDS

The Hospital Readmissions Reduction Program (HRRP) allows CMS to penalize hospitals with...Read More »

by Amy Czahor, RHIT, CDIP, CCS
Recently I was reviewing a data sample investigating the root cause of DRG discrepancies between CDI...Read More »

by Bonnet Tyndall, RN, CCDS

Mortality reviews are becoming more prevalent in the CDI world. But what do they really mean for CDI...Read More »