Quality & Regulatory

Two physicians and three nurses were sentenced last week in a $11.3 million Medicare fraud scheme involving false and fraudulent claims for home...Read More »

The rate of most HACs continued to decline from 2014 to 2016, according to the latest national...Read More »

By Cheryl Manchenton, RN, BSN, CCDS

If you search for Patient Safety Indicator (PSI) 90 (Patient Safety and Adverse Events...Read More »

Q: How can we help our physicians improve their documentation of medical necessity?Read More »

The Leapfrog group is launching a national survey to evaluate the safety and quality of up to 5,600 surgery centers that perform millions of...Read More »

The number of upcoded cases for patients who underwent gastrointestinal (GI) surgeries increased over a 10-year period, according to  a...Read More »

UnitedHealthcare announced recently that, starting January 1, 2019, they will use sepsis-3 criteria for validating sepsis claims.Read More »

It seems that there’s a new headline every day related to denials and audits. Not much has changed when it comes to the content of those...Read More »

Like a well-oiled machine, each component—or revenue cycle department—must function optimally to perform at its peak. Therefore, denial avoidance...Read More »