ACDIS/AHIMA release new query practice brief, are you ready?


By Brian Murphy The new ACDIS/AHIMA Guidelines for Achieving a Compliant Query Practice are out. Why care about this new guidance? The Guidelines are not law or regulation, but they are the standard that the two organizations recommend everyone follow. And that means literally everyone involved in the query process—CDI and coding of course, but…

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A football mindset, delivered with a nurses’ caring: Meet Robin Jones, Executive Director of Clinical Excellence, AdventHealth

off the record

What prompts a nurse working at the bedside to get into clinical documentation integrity (CDI)? Long, draining shifts, and burnout, are among a few that I’ve heard. Others include a desire to put their clinical acumen and physician communication skills to work in a different, less physically demanding capacity, but one that still engages the…

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Population Health: Eight Strategies for Success

population health

By Brian Murphy Note: This is the second in a two-part series on how mid-revenue cycle professionals can successfully operate in population health. View part 1 here. Population health is the current buzzword in healthcare. But do you know how to succeed in these environments? Population health initiatives often stall due to silos within the…

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Meet the Director of CDI and Utilization Management at Essentia Health, Tracy Boldt

director of cdi

“I like unique. Tell me something I don’t know.” That certainly describes this week’s guest. Tracy Boldt is the Director of CDI and Utilization Management at Essentia Health in Minnesota. Since September 2016 Boldt’s role has included providing leadership, direction and support in the development and management of CDI and UM at multiple Essentia Health…

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From meeting planner to medical coder … meet UC Davis’ star director of CDI and coding, Tami McMasters Gomez

cdi and coding

Tami McMasters-Gomez, BS, CCS-P, CDIP, CCDS, (MHL), is the Director of CDI and Coding Operations at UC-Davis Health in California. She has ultimate oversight of 80 employees, a team that is busy querying, coding, and abstracting data for a huge organization that includes its flagship 646-bed multispecialty academic medical center. Tami is a bright light…

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“To be a good leader you have to get your hands dirty” : Meet Angie Comfort, LifePoint Health

To say LifePoint Health is a large healthcare system is like saying Nashville has a few good country music bands. Per its website, LifePoint’s healthcare delivery network spans 29 states and includes 62 community hospital campuses, 33 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum including…

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Cigna’s OIG Takedown a Thing of Beauty in an Ugly War

oig takedown

By Brian Murphy Many on the provider side of healthcare—including coding/billing/CDI/case management professionals—are not the biggest fans of Medicare Advantage (MA), aka, the semi-privatization of Medicare. MA has been under the spotlight recently for denying medically necessary care, as well as failing to demonstrate better outcomes despite charging higher premiums. But I have to hand…

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CDI, denials, UM, and case management, under one roof? No problem. Meet Susan Fantin

Susan Fantin, MSA, BSN, RN, CCDS, CDIP, is the Vice President of Integrated Care Management for McLaren Health in Grand Blanc, Michigan. A one sentence description that is a woefully inadequate descriptor of what she does. All of CDI, case management, utilization management, and denials run through Susan’s capable hands. Think, massive responsibilities. A staff of…

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