In this article, we discuss the benefits of coding and case management (CM) collaboration – in particular, the value of CM documentation. By no means is this going to be an article about how case management should be cross-trained to learn coding. However, we believe there is value in coding professionals being able to engage […]
Prevention of readmission denials improves case mix index (CMI), reimbursement, and quality metrics. As a consultant, I am like the FBI – if you invite me in, I will likely take your case. This often leads to varied and challenging projects. Often, I am engaged to assess opportunity in provider documentation, clinical documentation integrity (CDI) […]
Ultimately, a CDI program is only as good as how you use the data. Data can be a powerful tool. It is important to remember not to just capture data but to use it. Over the past week you can see articles on clinical documentation integrity (CDI) impacting patient care. The question is how do […]
As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president of R1 RCM, to summarize the most pertinent regulatory changes recently arising. The following is a transcript of his reporting today on Monitor Mondays. “First, thank you, everyone, for continuing to care for patients and continuing to take this pandemic seriously,” Dr. Ronald Hirsch […]
Suggestions for conducting peer-to-peer appeals for denials. If you are wondering why you should read this if you think you are not a rebeginner, well, it is because you actually are one. Beginnings do not disappear, they just reproduce. Novices are just starting, veterans have started over and over. We all begin as beginners and […]