The Office of Inspector General (OIG) will begin reviewing Medicare payments for COVID-19 discharges, according to a recent update to its ...Read More »
Did you know that nearly 41% of CDI departments are involved in the denials management or appeals process and nearly 40% of their denials come from private payers? Did you know that more than 80% of CDI professionals query, even when the query outcome only impacts a quality measure rather than...Read More »
The California Department of Managed Health Care (DMHC) has fined Aetna $500,000 for denying almost 93% of investigated emergency department (ED) claims. The fine is the result of Aetna wrongfully denying their members...Read More »
ACDIS is looking for folks to submit their ideas for the next, and last 2020 edition (November/December) of the CDI Journal. This edition is focused on denials management and appeals.Read More »
According to a status report, the United States Department of Health and Human Services (HHS) has reduced its backlog of Medicare appeals at the Administrative Law Judge level by 43% through...Read More »
Q: Our dietitians send cases needing a query for malnutrition to our CDI staff. Previously, they were notifying providers of the need for the documentation of the diagnosis directly, but from a compliance perspective, they were more comfortable with us owning the formal query...Read More »
According to an audit from the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG), the Ohio State University Hospital received millions in overpayments during the audit period because of coding and...Read More »
