When will we implement ICD-11 for use on healthcare claims in the US? That’s a question everyone wants the answer to, but the true answer is – no one knows. However, when we know the answer on the following three key questions, we’ll be able to predict the implementation date in the US. Will the… Read More »ICD-11 Implementation Date
By: Natalie Sartori, M. Ed., RHIA, CCS This whitepaper is the first in a 2-part series regarding UASI inpatient and outpatient analyses of third party compliance work plans (including the OIG and RACs for example). This document details an analysis of the following active inpatient topics: Medicare Payments for Inpatient Discharges with COVID-19 (OIG) Deep… Read More »UASI Compliance Work Plan Analysis – Inpatient Documentation and Coding Issues
By Mary H. Stanfill, MBI, RHIA, CCS, CCS-P, FAHIMA; Pat Maccariella-Hafey, RHIA, CDIP, CCS, CCS-P, CIRCC; Christi LeBlanc, MBA, RHIA; and Janice Noller, RHIA, CDIP, CCS, CICA When COVID-19 emerged in early 2020, new ICD-10-CM codes to identify this condition were not available. Subsequent ICD-10-CM codes and guidelines for reporting COVID-19 changed many times as the pandemic… Read More »UASI in JAHIMA: COVID-19 ICD-10-CM Coding Timeline for Outpatient Services
It has become increasingly important for health information management (HIM) departments to have strategies for tackling denials management. It is in every organization’s best interest to develop a proactive approach to denials management. While many are already doing this work, consistent and constant management of the denials process is essential. The following list—while not exhaustive—includes… Read More »UASI in JAHIMA: Top Ten Tips for Denials Management
Top Documentation and Coding issues to include in 2020 Compliance Plans What’s in your 2020 compliance plan? Make sure you are addressing these top ten documentation and coding compliance concerns. For Hospitals Risk-based review of inpatient DRG cases, examples include: RAC DRG targets Clinical indicators, cases at risk for clinical denials (e.g. Sepsis, CHF, ARF,… Read More »Top 10 Compliance Issues 2020
Click here to download our article “Preventing Denials Through Clinical Validation,” originally published in the March 2020 issue of the Journal of AHIMA.
Click here to download our article “Components of an Effective Inpatient Coding Compliance Program,” originally published in the January 2019 issue of the Journal of AHIMA.
How to Get From Revenue Integrity to Revenue Intelligence For health systems and hospitals, claims denials have a significant impact on overall financial performance. From lost charges and Medicare/Medicaid cost outliers to defensive and forensic audits, the impact can reach into the tens of millions of dollars for large systems. The regulatory consequences can also… Read More »Six Rules for Successful Denials Management
UASI’s health information management (HIM) experts continue to set the pace in this fast-evolving field. Our vice president of HIM consulting services, Mary Stanfill, MBI, RHIA, CCS, CCS-P, FAHIMA, co-authored a paper — published in the June 2018 issue of the peer-reviewed Journal of the American Health Information Management Association (JAHIMA) — that explored the… Read More »UASI in JAHIMA: “Documentation and Coding Practices for Risk Adjustment and Hierarchical Condition Categories”
For many years, coding audits have been commonly-employed to make their revenue cycles more efficient. Now, they’re becoming mission-critical. In a new, peer-reviewed article out this month in the Journal of the American Health Information Management Association (JAHIMA), UASI’s manager of HIM consulting Kathy DeVault and corporate educator Natalie Sartori showed how coding audits are… Read More »UASI in JAHIMA: “Auditing Across the Continuum”