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University of Utah Health: Making the Case for Auditing CDI Queries

The University of Utah has taken a unique approach to CDI. They have determined that standards and auditing are critical components of the CDI process. But how does a facility begin auditing queries? And what constitutes a compliant query?

Cultivating Homegrown Inpatient Auditors

By training coders who already are on staff, hospitals leverage institutional knowledge and build career paths. Changes in payment policies, laws, and regulatory oversight are forcing healthcare organizations to respond to increased regulatory scrutiny and audits. Medicare audits have increased by 936 percent in the past five years*. Ad hoc inpatient audits are no longer enough […]

Key Learnings from HCCA 2018 Compliance Institute Conference.

We had a great time at HCCA’s Compliance Institute conference in Las Vegas and enjoyed meeting everyone.  It’s always so exciting to see all of the strategies and methods professionals across the healthcare industry are using to accomplish their diverse goals.

IR Coding: 100% Bundled, Component Coded or Hybrid-Bundled

In 1992, CPT coding options for interventional radiology (IR) procedures underwent a seismic shift in “how” to code. Gone was the old method of complete procedure codes (a one-size-fits-all code); the new method added separate options to describe “what was done” and “where or how you did it.”

Renown University: How One Organization Cultivated Their Own Coding Team and Saved 2.27 Million

Like many other organizations, Renown faced significant challenges finding experienced coders. In 2014, they decided to develop their own coding team and started their own coding educational program called Renown University.

Webinar: A Pharmacy Revenue Team Conversation: The Top 4 Reasons Why Pharmacy Revenue Improvement Should Be Your Next Project

With the focus on improving revenue cycle over the last few years, it is now time to tackle one of the most complex areas in healthcare organizations — the pharmacy

Large Healthcare System Enhances Revenue Capture and Reduces Compliance Risk

A large multi-institutional healthcare delivery system wanted to develop a charge capture program that would help all their hospitals ensure appropriate reimbursements. The solutions they considered didn’t cut it—until they found CLAIMSauditor.

The OIG Targets Herceptin Billing Errors

The OIG has added specialty drug coverage and reimbursement by Medicaid to its Work Plan.

Creating an Internal Inpatient Auditing Program

Changes in reimbursement policies, laws, and regulatory oversight are forcing healthcare organizations to respond to increased regulatory scrutiny and audits.

Webinar: How to Cultivate an Inpatient Auditing Team and Ensure You Have the Right Professionals

With ever-intensifying financial scrutiny and an increasingly complex…