This week's note from the instructor discusses the steps involved in the prior authorization process for certain hospital outpatient department services.
EHRs hold all the important information about patients’ medical histories and demographics. Learn how gender-inclusive EHRs can improve quality of care and ensure more accurate and complete medical records.
Coding audits are essential to ensuring compliance but without defined processes these audits may lack focus and consistency. Understand how to create strong processes for targeted, consistent, and accurate coding audits.
Among the proposed changes, many of which affect quality and data reporting programs, are proposed changes to claims data used for rate setting, a delay of the three way split criteria for Medicare Severity Diagnosis-Related Groups (MS-DRG), and more. Understand major proposals and their potential impact and how to provide feedback to CMS.
As hospitals face mounting challenges, preventing and managing denials is more important than ever. Learn how to use data from electronic remittances to conduct root cause analysis and stay ahead of potential future denials.
CDI’s work touches nearly every facet within an organization, from the business departments (e.g., financial, contracts, denials management, etc.) to clinical initiatives.
Correct coding for mechanical ventilation depends upon a thorough grasp of medical terminology and coding guidelines. Brush up on your knowledge of mechanical ventilation coding to ensure it's done right.
Denials management has gained new urgency as payers adopt more aggressive tactics and hospitals continue to face revenue shortfalls. Learn how organizations are structuring denials management and reporting denials and appeals data.
