Podcast
Payers turning to clinical validation to ignore coding guidelines, deny claims
By Brian Murphy Clinical validation audits are on the rise and among the chief causes of claims denials, per my current Off the Record podcast guest Richelle Marting, JD, MHSA, RHIA, CPC, CEMC, CPMA, CPC-I. While denials are payer-agnostic, Marting says that Medicare Advantage Organizations have risen to the top of worst offenders.…
Read MoreNo one will hire a CPC-A, or a coder without experience? Think again
By Brian Murphy “Nobody will hire a CPC-A.” “Nobody will hire without experience.” My recent guest on Off the Record, Revka Stearns, describes these oft-expressed statements as not factual. And rightly so. If they were, no one new would ever be hired. Which of course cannot be the case, and is not…
Read MoreClinical (and career) validation: Richelle Marting on legal aspects of HIM, CDI
Listen to the episode: https://spotifyanchor-web.app.link/e/FV3hTItIZJb Earning your RHIA (Registered Health Information Administrator) is a huge accomplishment, and for some marks the end of a four-year academic journey and an entry into HIM. For Richelle Marting, it was only the beginning. In pursuit of her RHIA, which she eventually earned, my guest on today’s episode took…
Read MoreBattle over Sepsis-2 vs. Sepsis-3 Heating Up
By Brian Murphy The battle over Sepsis-2 vs. Sepsis-3 continues. Advocates of Sepsis-3 state that it offers a more clinically accurate and rigorous definition, and that sepsis-2 is too vague to be truly useful. Advocates of Sepsis-2 believe that it’s more sensitive and superior for early detection, and sepsis-3 too high a bar to capture…
Read MoreBack to Documentation School: Lessons from CDI Educator Kalee Vincent
Listen to the full episode here: https://spotifyanchor-web.app.link/e/AzfGTtkICJb One of the more promising developments I’ve seen over my career watching the CDI profession bloom is the creation of the CDI educator role. CDI is often labeled by its critics as reactive, sending queries to the provider after he or she has already documented in the chart.…
Read MoreDecoding Sepsis: A Clinical Nurse Specialist’s Frontline Perspective
Listen to the full episode here: https://spotifyanchor-web.app.link/e/deiNqUvFgJb Sepsis it seems is always in the news, never far from anyone who works in CDI or coding circles. And here we are again, back in the headlines due to its inclusion in the Office of Inspector General (OIG) Work Plan. Sepsis has been discussed so…
Read MoreClinical Clarity: Navigating Problem Lists and Defensible Narratives with Dr. Trey LaCharite’
Listen to the full episode here: https://spotifyanchor-web.app.link/e/mQEUhXavSIb If you’ve ever been a member of ACDIS you’ve almost certainly encountered Dr. Trey LaCharite’. ACDIS advisory board member? Check. Regular columnist for CDI Journal? Check. Author of the CDI Field Guide to Denial Prevention and Audit Defense? Check. Speaker at the physician advisor pre-conference every year since…
Read MoreRx for rural community health: CDI on a shoestring with Jennifer Cummins
Listen to the full episode here: https://spotifyanchor-web.app.link/e/uVBMHJadvIb Small community hospitals are the backbone of healthcare for most of the country, even today in this era of sprawling healthcare organizations and massive mergers. But while they’re critical to the health of our nation, resources are often scarce, and CDI is no exception. Jennifer…
Read MoreBurd(a)’s eye on Medicare Advantage: What does the future hold?
Listen to the full podcast here: https://spotifyanchor-web.app.link/e/U0Dxkanv7Hb I don’t know about you but I’m FASCINATED with Medicare Advantage (MA). Massive growth, fueled by its shrewd marketing of added benefits beyond traditional Medicare. But also chaotic, messy, a program in need of reining in. It’s a bit of the wild west. I like…
Read MoreMalnutrition Deep Dive: A Conversation with ECU Health’s Ashley Strickland
Listen to the full episode here: https://spotifyanchor-web.app.link/e/S5y8KpFOKHb Listeners of Off the Record may recall our episodes on the OIG audit of severe malnutrition directed at North Carolina based Vidant, now ECU Health. Vidant/ECU won a landmark case against the OIG in large part because it had a multidisciplinary clinical and coding team in place to…
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