HIM Briefings

Contract negotiations can make or break a hospital, because in addition to setting the price list for services provided to the insurer’s members, the negotiations also affect the resources that the provider expends to comply with the contract terms. Use this sample language as a template for your organization.

Several proposals in the fiscal year 2024 Inpatient Prospective Payment System (IPPS) proposed rule signal that CMS is serious about a major overhaul of MS-DRG severity levels. Review these and other major proposals to help your organization prepare for the release of the final rule.

When a CDI program is renewed or created, the main focus tends to be on the CDI department structure: its policies, education, staffing needs, and key performance indicators (KPI). Learn how to identify KPIs for your CDI program.

Coders are now tasked with reporting social determinants of health, or circumstances in patients’ lives that can influence the quality of their life and overall wellbeing. Understand how to improve documentation of these factors and ensure complete and accurate coding.

As CDI programs are created or renewed, the main focus tends to be on the CDI department structure: its policies, education, staffing needs, and key performance indicators (KPI). Hone your understanding of appropriate CDI KPIs.

Defining the line between a coder comprehending the record’s meaning and interpreting documentation can be a challenge. Consider these ways to improve documentation and foster critical thinking in coders.

There are many things that can go awry during gestation resulting in a neonate with temporary or permanent health conditions. Physicians have found ways to treat many congenital defects in utero, enabling the neonate to be born without defects. Review coding guidelines for fetal surgeries.

Organizations must ensure their procedures are aimed at preventing and managing denials. One way to accomplish this is by looking for opportunities to involve other departments. Use these tips to improve interdepartmental denials management.