Quality & Regulatory

Leah Burton, CPC, CPMA, and Julie Bell, BSN, RN, CCDS, CCS, CRC

Many organizations are interested in addressing Hierarchical Condition Category (HCC) opportunities but don’t have the budget to hire expert staff for these reviews. This session will show how organizations can...

James Fee, MD, CCS, CCDS

As the healthcare industry shifts from a reactive “sick” delivery model to one that focuses on healthy lives through prevention, how does CDI evolve provider collaboration while supporting the sustainability of healthcare as a business? In this session, a...

Sherry Goyal, MD, MBA, CHRI, CPC, CRCS

CMS introduced the Medicare Integrity Program to optimize hospital reimbursements for medically necessary and covered services and ensure long-term financial viability of Medicare insurance coverage while discouraging fraud, abuse, and...

Jaime Bennett, BSN, RN, Sheila Wade, MSN, RN, NEA-BC, and Lydia Koepke, MS, APRN, RN-BC, CWON

Learn how Northwest Medicine created a role for a CDI nurse to facilitate multidisciplinary concurrent and retrospective reviews, ultimately resulting in a 38% reduction of Patient...

Cheryl Ericson, RN, MS, CDIP, CCDS

The financial pressure on hospitals and healthcare systems continues to grow following COVID-19, as hospitals have reached their highest case-mix index, and proving continued financial return on investment becomes increasingly difficult. This...

Julie Morales, BSN, RN, CCDS
Dawn Vitalone, RN, CCDS, CIC

Healthcare systems and CDI program leaders place great importance on quality. However, with numerous areas to consider, such as Medicare star ratings, Patient Safety Indicators, and Elixhauser, it can be daunting to...

Amy Pritchett, CCS, CRC, CPA-RA, CPC, CPCI, CPMA, CPCO, CDEI, CDEO, CDEC, CANPC, CASCC, CMPM

This session will begin by delving into the complicated world of risk adjustment and end with the transition from Version (V) 24 to V28 for Medicare Advantage plans. The speaker will also...

Adriane Martin, DO, FACOS, CCDS

Many organizations are looking for opportunities to bring in new processes to enhance revenue capture or to make existing processes more efficient to reduce costs. By thinking outside of the box and taking an innovative approach to the mid-revenue...

Brianna Brown, MSN, BSN, RN-BC
Dana Jones, BSN, RN, CCDS

Regulatory agencies’ specifications and guidelines can create conflict among departments that are all working toward the same goal: quality patient care that is accurately reflected in the medical record. Learn how...