Ten Tips for Writing Effective Appeal Letters

UASI Solutions

1. Review every denial to determine the validity of an appeal. If the denial is valid, do not appeal. However, appeal every case where there is documentation to support original coding. 2. Determine the nature of the denial (e.g. clinical validation and/or coding issue) and seek the relevant clinical and/or coding expertise to write the…

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UASI Experts to Present “Key Steps to Successfully Implement Outpatient CDI in Physician Practice” at AHIMA 2018

Successful Implement Outpatient CDI

HIM directors, coding managers and healthcare leaders consistently tell us that accurate hierarchical condition category (HCC) capture, coding error prevention and compliance planning remain top-of-mind. It’s critical that provider groups broaden their understanding of these areas — especially as they pertain to outpatient settings — and address them in their clinical documentation improvement (CDI) efforts….

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UASI Experts to Present “Creating and Retaining the Best CDI Team” at AHIMA 2018

Clinical documentation improvement (CDI) — particularly in outpatient settings — continues to be a top priority for US healthcare organizations as they prepare for their transition to value-based reimbursement models. Right now, there’s a tremendous amount of pressure on hospital groups to recruit top CDI talent and implement robust programs that improve patient data accuracy…

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UASI Experts to Present “Compliance Risks Associated with DRG Mismatches” at AHIMA 2018

Compliance Risks Associated with DRG Mismatches

The American Health Information Management Association’s (AHIMA) 2018 gathering is coming soon and among the hot topics to be discussed this year are diagnostic related group (DRG) mismatches and the negative revenue pressures resulting from them. Mary Stanfill, UASI’s VP of HIM consulting, and our HIM consulting manager, Kathy DeVault, have developed an engaging, interactive…

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UASI in JAHIMA: “Documentation and Coding Practices for Risk Adjustment and Hierarchical Condition Categories”

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…

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UASI in JAHIMA: “Bridging the Gap Between Coding Guidelines and Sepsis Clinical Criteria”

UASI Solutions

In the January 2018 edition of the peer-reviewed Journal of the American Health Information Management Association (JAHIMA), UASI corporate trainer Natalie Satori, MEd, RHIA, published an article that seeks to clear up some of the confusion surrounding clinical criteria, as they pertain to coding guidelines and clinical validation specifically for sepsis.

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