Quality & Regulatory

by James S. Kennedy, MD, CCS, CDIP, CCDS

Physicians are ethically engaged in keeping patients safe and doing no harm....Read More »

Last week, CMS announced new initiatives to improve Medicaid program integrity “through greater transparency and accountability, strengthened data...Read More »

At the beginning of the 2018, CMS announced the...Read More »

Q: What is a good strategy for sharing denials data with the medical staff to ensure they understand...Read More »

By Allen Frady, RN-BSN, CCDS, CCS, CRC

Be aware of payer’s “home cooked” clinical criteria which are often not only outdated, but...Read More »

by Allen Frady, RN-BSN, CCDS, CCS, CRC
More than a decade ago, I received a claim from patient financial services with a denial due...Read More »

by Trey La Charité, MD, FACP, SFHM, CCS, CCDS
Like it or not, provider documentation is the foundation for everything done in...Read More »

Last week, the AHA submitted four, non-deadline related remedies to reduce the backlog of Medicare billing appeals awaiting adjudication at the...Read More »

Q: What’s the difference between RACs, MACs, and the CERT?Read More »

Examining readmission and mortality changes from 2010 to 2016, MedPAC found the HRRP contributed to a significant decline in readmission rates...Read More »