Like a well-oiled machine, each component—or revenue cycle department—must function optimally to perform at its peak. Therefore, denial avoidance is a cross-functional, ongoing initiative. The departments with the most involvement are typically patient access, care management, patient financial...Read More »
Denial management is traditionally focused on improving hospital revenue cycle and financial performance. Appropriate routing and handling of denials from third-party payers improves net revenue and cash flow, and reduces rework.Read More »
Whether it be medical necessity, clinical validation, or coding-related—denials seem always on the rise. And those involved in denials management and appeals know how far reaching the...Read More »
When it comes to children’s hospitals, U.S. News and World Report is perhaps the most ubiquitous, and arguably, it uses the most clear-cut methodology for data abstraction.Read More »
By Laurie L. Prescott, MSN, RN, CCDS, CDIP, CRC, and Sharme Brodie, RN, CCDS
The inpatient prospective payment system (IPPS) requires all facilities to report a present on admission (POA) indicator (or code) for all claims. There is no required time frame as to when a provider...Read More »
by James S. Kennedy, MD, CCS, CDIP, CCDS
Many hospitals find that their patient safety indicator (PSI) ratios remain high despite doing a spectacular job of addressing these events and exclusions.Read More »
Physicians are ethically engaged in keeping patients safe and doing no harm. Unfortunately, medical and surgical care is complicated, especially in patients with high-risk comorbidities; thus, unintended negative results do occur.Read More »
