Conference conversations: Combs discusses denials determent tactics
RN, MSN, CDIP,
CCS, CCDS
Editor’s note: Tammy Combs, RN, MSN, CDIP, CCS, CCDS, will present “How to Mitigate and Manage Denials,” on Day 2 of the ACDIS conference. Combs is the director of HIM practice excellence, CDI/nurse planner at the American Health Information Management Association (AHIMA) in Chicago, Illinois. This year’s conference takes place May 21-24 at the Henry B. Gonzalez Convention Center in San Antonio, Texas.
Q: In what ways are CDI professionals well-positioned to mitigate and manage denials?
A: Many denials occur secondary to missing documentation. CDI professionals are at the forefront of this issue, as they review heath records to ensure documentation is thorough and accurate. It only stands to reason that if documentation improves, denials for missing or lack of documentation will decrease.
Q: What's one thing attendees can expect to come away with from your session?
A: Attendees will walk away with a better understanding of the denials process and procedures that can be implemented to help reduce denied claims.
Q: What's one way CDI teams can use denials data to shape their CDI work?
A: Tracking denials data can help guided education for the denials team, including providers. If we understand what is being denied then we can develop a process to mitigate them. For example, if an organization is seeing a high number of denials due to a lack of clinical evidence to support a diagnosis, an organization can work with their medical teams to develop clinical guidelines.
Q: In what ways does your session challenge CDI professionals to think outside the box?
A: CDI professionals have not always been involved in the denials process. Learning something new can be an intimidating process. This session will demonstrate how CDI professionals can leave their comfort zone and learn that becoming part of the denials process can enhance their CDI practice.
Q: What one thing are you excited for at this year's conference?
A: Meeting all the wonderful attendees and presenters.
Q: Fun question: What's your favorite hot beverage?
A: Coffee, with lots of creamer.