HIM Briefings

Analyzing data that comes from claim scrubber edits, return to provider edits, variances, and denials can provide insight into repetitive issues that delay the processing of a claim or lead to denials. Use these tips to improve your organization's pre-billing analysis processes.

Regular charge reconciliation is a cornerstone of complete, compliant reimbursement but is a common weak point for hospitals. Apply these tips to support clinical staff responsible for charge reconciliation and improve charge capture.

CMS recently revised the evaluation and management (E/M) coding guidelines for inpatient providers. Understand the far-reaching effects of the changes and how to ensure your organization is in compliance.

Payer audits are likely to pick up steam as the COVID-19 public health emergency expires. Experts share tips for managing audits and what types of claims payers may focus on.

Sepsis is a systemic, deleterious response to infection that can lead to severe sepsis and septic shock. Brush up on sepsis criteria and documentation and coding guidelines.

Use this sample payer charge denial letter as a template when drafting appeal letters.

Chronic obstructive pulmonary disease (COPD) is a group of obstructive lung diseases characterized by airway obstruction or narrowing and difficulty breathing. Brush up on coding guidelines for this condition.

There is no single query format every organization uses. Learn how to use resources and guidelines to create a compliant query template for your organization.

by Trey La Charité, MD, FACP, SFHM, CCS, CCDS