PPT-Clinical Validation: A Denials Perspective

Kathy Shumpert RN MSN CCDS Objectives 1 Need for organizational clinical markers 2 Importance of semantics in the physician documentation 3 Common clinical validation denials. With the help of Hélène MAINAUD-DURAND . And Mateusz SOSIN. BE/ABP/SU. CLIC MODULE. September 19 , 2011. Présentation. REPORT OF . THE CURRENT TESTS . RUDE Vivien. DRIVE BEAM. . MAIN BEAM. . Presentation of the mock up. Weaving together the Clinical, Technical, and Legal Components . Glen Reiner, RN, BSN, MBA, VP of Clinical Operations. 08.24.2012. An overview of effective Denials Management approach. Key Performance Indicators – MAP Keys. Sustaining a Financially Healthy . Critical Access Hospital. June 15, 2015. Agenda. Critical Access Hospital (“CAH”) and PPS Hospitals. CAH Payments. IP Admissions. Reasonable Cost Payment Principles That . Colin Batchelor. ,. Ken Karapetyan, Valery Tkachenko, Antony Williams. 6th Joint Sheffield Conference on . Chemoinformatics. 2013-07-24. Overview. Open PHACTS and chemical validation and standardization. . Making sense of government audits. . . Jennifer Ogden. Audit Solutions Manager. Agenda. Recovery Audit Contractors . Auditor Overview. Audit Process. Data Analysis. Upcoming changes. Why is it important to you?. Nancy l. thygesen, rhia. “confidential and privileged, all rights reserved, lutz”. ICD-10. ICD-10 Information. Implemented . October 1, . 2015. First . set of updates effective October 1, 2016. . April 2017. Presenters. 2. - Proprietary and Confidential -. Peter . Angerhofer. Peter . is a principal at Colburn Hill Group; he brings experience in operations, strategy and health policy to both daily operations as well as long-term vision.. By Melissa Blank-. Harbert. , Vice President &. Nancy Binder, Executive Director. Denials. Documentation is key to Denial Prevention. Denial Prevention – Best Practice . Agenda:. Denial Reasons / Root . Presenters. 2. - Proprietary and Confidential -. Peter . Angerhofer. Peter . is a principal at Colburn Hill Group; he brings experience in operations, strategy and health policy to both daily operations as well as long-term vision.. for Diagnostics: New York State’s Experience Monica M. Parker, Ph.D. Reflexing to an HCV RNA test after a reactive antibody test is the recommended practice for laboratories 2 Several FDA - ap Compiled by . Coral . F. Fernandez, RN CCDS CCS. August, 2017 – September 2018. 1. INTRODUCTION. Coral F. Fernandez, RN CCDS CCS. 27 years with Baptist. 2. years as a file clerk in HIM (prior to EMR). Charity Hilton MS. 1. , Saul Crumpton MS. 1. , Jon Duke MD, MS. 1,2. 1. Georgia Tech Research Institute, . 2. Georgia Institute of Technology. Background. OHDSI Atlas has long been an effective tool for developing rule-based cohort definitions in observational data. In the public version of Atlas, thousands of cohort definitions have been created. While patient record verification is a common method of cohort definition validation, it is not without difficulties, including but not limited to the need for clinical experts to access data, a tool to review all in-cohort patients, a method to gather review data, and a system of tabulation to determine in-cohort (case/no-case) participation or not. Presented to the WA and OR State ACDIS Chapters. 4/6/2018. Cathy Farraher, RN, BSN, MBA, CCM, CCDS. CDI specialist . Newton-Wellesley Hospital. Farraher has a broad experiential base, from defending RAC auditors, Legal Nurse Consulting, many years of Case Management Consulting, Off-Shift Nurse Management as well as hands on ICU, oncology/BMT and telemetry nursing at Brigham and Women’s Hospital prior to embarking on her CDI career. . Haaris Ali, MD, CDIP. ACDIS . Agenda. Denials. Commonly Used Terminology. Root Causes. Denials Management and Prevention. What We See and Why. How CDI Plays a Vital Role. The Comprehensive Solution. Current Payor Trends.