The roles and responsibilities of the HIM department have been transformed over the past decade. Although many of the core functions—coding, transcription, ROI—remain at the heart of the department, the way these tasks are performed has changed over time. As newer fields such as CDI or revenue integrity grow, they can open up questions about what role the HIM department plays in the organization and move critical HIM functions out of the department’s direct oversight.
As hospitals transform from volume-based to value-based reimbursement, the role and functions of the utilization review (UR) committee are evolving. Learn how to refocus UR and use it as a tool for success now and in the future.
Patient matching—associating the right patient with the right medical record—isn’t a new problem, but as the practice of medicine and reimbursement models become more data-driven, the stakes will continue to rise.
Establishing an outpatient CDI program can have substantial benefits. Recently, an outpatient CDI review project demonstrated there were many documentation improvement opportunities at a large family practice/internal medicine physician clinic.
Implementing a denial avoidance initiative can help facilities and health systems realize lost revenue, achieve cost savings, and improve an organization’s financial performance.
