Denials & Appeals

By Rachel Strom, RN
Yes, I’ll admit it, I used to be one of those people, I am a former Medicare Administrative Contractor (MAC)...Read More »

By Janie L. Brown, RN
Denied. It’s a word that no one wants to hear in any context. In healthcare, it’s a heavily weighted word. It...Read More »

FEATURES

8 The denials landscape: Physicians’ perspectives

14 CDI specialists see an inside scoop on denials...Read More »

by Melissa Varnavas

Documentation improvement efforts related to denials management and audit prevention feel a lot like a trip...Read More »

A patient comes into the hospital, so sick that there’s likely no coming back. The physicians do everything they can, but the patient expires....Read More »

By Tamara A. Hicks, RN, BSN, MHA, CCS, CCDS, ACM-RN
The old adage, “the best defense is a good offense,” comes to mind when I think...Read More »

Trey La Charité, MD, FACP, SFHM, CCS, CCDS
Appeal writing, like most things in a hospital, is a learned skill. Keeping things...Read More »

by James S. Kennedy, MD, CCS, CDIP
Over the years there’s been a tsunami of denials from payers, Recovery Audit Contractors (RAC),...Read More »

Because of payers’ propensity for denials, facilities need to have a process in place for managing denials’ root causes on the front end and...Read More »

Only 28% of CDI specialists are involved in the denials prevention and appeals process, according to a poll on...Read More »