Background: Accurate coding is paramount to hospital revenue generation and is often supported by a clinical documentation integrity (CDI) team made up of registered nurses and non-clinical coding personnel. Physician-led coding initiatives have demonstrated improvement in case-mix index and clinical documentation. We hypothesized that physician integration into CDI would result in a more robust improvement [...]

Background: As the landscape of health care access and delivery has changed over the past 10 years, areas of coding, documentation, denials management, appeals, and reimbursement have become more confusing to navigate for most physicians delivering direct patient care. The physician advisor is an experienced physician who understands the rules and regulatory issues involving patient [...]

Background: Upon hospitalization, patients are assigned to an inpatient or an outpatient status for the hospital stay. Failure of this status to match the requirements of the Centers for Medicare & Medicaid Services may lead to lost revenue or increased risk of audits and penalties. Timely ordering of observation services for patients with an outpatient [...]