Not all CDI teams are directly involved in the denials management or appeals process, but every CDI professional knows the value of avoiding a denial in the first place.
CDI departments employ many methods, often concurrently, to target different issues related to their organization’s denial trends. Though I’m still learning every day, my continuing education on the complex world of CDI has taught me how frustrating of a problem payer denials can be.
Jeni Rae Peters would make promises to herself as she lay awake nights after being diagnosed with breast cancer two years ago.
"My kids had lost so much," said Peters, a single mom and mental health counselor. She had just adopted two girls and was fostering four other children. "I swore I wouldn't force them to have yet another parent."
Elizabeth Woodruff drained her retirement account and took on three jobs after she and her husband were sued for nearly $10,000 by the New York hospital where his infected leg was amputated.
Minnetonka-based United Healthcare announced it would pledge to have no “out-of-pocket” expenses for diabetes patients who cannot afford insulin medication starting January 1.
A Centers for Medicare & Medicaid Services proposal to pause public reporting on the inpatient patient safety indicator measure for one year due to the pandemic “is not only consistent with a commitment to transparency, but important for maintaining the credibility of the information shared with the public,” writes Akin Demehin, AHA’s senior director of quality and patient safety policy.