The CDI Field Guide to Denial Prevention and Audit Defense, Second Edition helps CDI professionals understand the role of recovery auditors in private and governmental reimbursement efforts, various audit contractors and their scopes of work, and the importance of CDI and query compliance in denials prevention. La Charité also explains how to identify possible documentation risk associated with the growing use of electronic health records as well as how to establish an effective appeals process at your organization.
Understand how your CDI program can help defend your facility’s medical records and claims submissions from recovery auditors to ensure the facility receives the appropriate reimbursement for its patient care. This second edition features new content, including:
A chapter focused on defending against clinical validation denials for specific diagnoses
Sample appeal letters for some of the most commonly denied diagnoses
An epilogue detailing one organization’s years long appeal journey
Explanations of how to identify possible documentation risk associated with the use of electronic health records
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