News & Analysis

September 30, 2020
HIM Briefings

Drafting an effective appeal in response to payer audits and overpayment demands goes beyond just coding and billing; it also often requires a deeper analysis and technical response. Discover methods to improve your appeals strategy with an eye on facts and compliance.

August 26, 2020
HIM Briefings

Determining which denials could be overturned on appeal is key to a successful denial management program. Learn how to leverage your appeal team's knowledge to create a data-driven scoring system.

August 26, 2020
Medicare Web

Q: As utilization review case managers, we are often tasked with assessing our hospital's risk for novel coronavirus (COVID-19) denials. What are the most important measures we should be examining?

August 10, 2020
Medicare Web

Q: Are commercial payers allowed to conduct a pre- and post-payment review of the same claim?

August 1, 2020
Briefings on APCs

Judith L. Kares, JD, writes about the unique coverage, billing, and payment rules that apply to these blood products and related services under Part B.

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.

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