News & Analysis

September 28, 2022
Case Management Monthly

Follow the cases of a patient known for refusing discharge and a patient who files a discharge appeal.

September 21, 2022
Case Management Monthly

A report released last month by the American Hospital Association (AHA), called Commercial Health Plans’ Policies Compromise Patient Safety and Raise Costs, found that not only is the cost of private health insurance raising affordability issues for American consumers, but policies, such as prior authorization requirements, may increasingly be putting patients at risk and driving up hospital administrative costs.

August 10, 2022
HIM Briefings

Revenue erosion and denials are often easily prevented, but simple errors may evade traditional, reactive denials management processes. Apply these tips to reduce and prevent common denials due to medical necessity, the three-day payment window, and more.

August 1, 2022
Briefings on APCs

The 3-day payment rule is known to coders by various names such as the 72-hour rule, the 3-day payment window, or MS-DRG window policy. Kimberly Lee M.Ed., RHIA, CCS-P, describes how to navigate the rule’s nuances for billing purposes.

July 13, 2022
Briefings on APCs

Every organization’s priorities will differ, but any outpatient CDI program must determine how to measure the improvement associated with its efforts. Outpatient CDI will directly contribute to the facility’s overall quality performance and risk adjustment models.

June 1, 2022
HIM Briefings

Hospitals have made avoiding and managing denials a top priority, but for many their best efforts have yet to turn the tide.