Q: We're looking for ways to bring our CDI and coding teams together to improve documenation and coding for appropriate Hierarchical Condition Categories (HCC) capture. Are there any recommended models and should other departments or individuals be working alongside them?
Many case management and finance departments have been busy with appeal activities since CMS resumed its regulatory audits on August 3, 2020. Utilization review (UR) nurses are reporting increasing numbers of commercial denials as the coronavirus (COVID-19) pandemic is resolving.
Q: One of the biggest challenges for case management directors is gaining the physician’s cooperation with documentation as they continue to face high patient volumes. What approaches should be taken to get physicians on the same page as case management directors?
