News & Analysis

July 22, 2020
HIM Briefings

The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a rich source of data. Consider how to use the PEPPER to guide coding and CDI process improvements.

July 15, 2020
Medicare Web

CMS is planning to restart most Medicare fee-for-service medical reviews by August 3 regardless of the status of the public health emergency.

April 22, 2020
HIM Briefings

Clinical validation reviews and queries ensure that the documented diagnoses and clinical indicators hold up to inspection. Use these strategies to head off clinical validation reviews and improve documentation.

December 11, 2019
HIM Briefings

Use these tips to craft targeted appeals letters for clinical and technical denials.

November 4, 2019
Medicare Web

Q: How should we handle denied claims when the payer refuses payment under the billed status? Do we need to document that the status was changed only because the payer did not agree to any other options?

October 2, 2019
HIM Briefings

Learn how your organization’s claim edit and denial management process compare across the industry.