Denials and appeals

Review education strategies for CDI professionals to improve documentation, reduce denials, and boost accuracy in medical records.

Analyze current denials trends to get a better understanding of your organization and potentially identify unknown issues.

Review up-to-date prevention and management strategies for three common types of denials.

Get back to the basics of sepsis documentation to combat the increasing rate of denials.

Use these tips to train your team on the latest definitions and coding guidance for diabetes screening and related services during your next training session. 

Ensure your queries are solid enough to protect your organization against denials.

Make sure staff who handle audit requests understand when a missing signature should — or should not — trigger an automatic denial of your claims or prior authorization requests. Recent guidance from CMS clarifies how auditors should proceed when a medical record lacks a signature.

Review updates in the 2025 Medicare Advantage (MA) and Part D final rule that could impact case management practices.

Kepro recently updated its discharge appeal process, bringing with it more work and new questions for case managers.

Follow the case of a patient who refuses to transfer until certain conditions are met.