In today's healthcare landscape, where operating margins are tightening and administrative burdens are increasing, hospitals face the critical challenge of ensuring they capture every dollar of earned revenue. While front-end revenue cycle activities like patient...
Blog
Why Providers Should be Documenting “Evidence of” a Diagnosis Based on Clinical Findings
CDI and coding professionals should consider the totality of the record when…
Optimizing Coordination Among Mid-Revenue Cycle Stakeholders
Learn about the specific outcomes of the emergency department pilot program during…
Is Everything in the Medical Record “Documentation”?
Do health information management (HIM) and clinical documentation integrity (CDI)…
Is There a Blind Spot in Your Mid-Revenue Cycle?
As a former manager of clinical documentation integrity (CDI) and utilization…
Healthcare-Associated Pneumonia: Why You Should Not Diagnose It
The diagnosis of Healthcare-Associated Pneumonia (HCAP) is clinically out of date…
Know the New Pediatric Sepsis Criteria
“Surviving Sepsis Campaign International Guidelines for the Management of Septic…
Optum (UHC) Profits from Denying ED Payments
Emergency departments (EDs), the US healthcare system “safety net”, are seeing…
Take control of Medicare Advantage denial challenges
The National Association of Healthcare Revenue Integrity (NAHRI) recently asked our…
Guest Blog: A Rebeginner’s Guide to Peer-to-Peer Appeals
Suggestions for conducting peer-to-peer appeals for denials. If you are wondering why…
Expand the role of the physician advisor to break down silos
I just returned from the ACPA National Physician Advisor Conference where I met…
Is your hospital slipping on industry rankings?
Do you recall the days of being graded on a bell curve? Your grade didn’t…