Coding managers should not assume that they can review every coding guideline, Coding Clinic, or coding-related issue targeted by the Office of Inspector General. Review considerations for conducting focused internal and external audits.
Tiffany Ferguson, LMSW, ACM, and Marie Stinebuck, MBA, MSN, ACM, CEO and COO at Phoenix Medical Management Inc., discuss why the best strategy to prevent denials related to medical necessity is a proactive approach that focuses on front-end processes.
Shelley C. Safian, PhD, RHIA, CCS-P, COC, CPC-I, unpacks local and national medical necessity standards and best practices for avoiding denials due to inadequate documentation.
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.
