Podcast

Listen to the episode here.   Medicare Advantage. It’s everywhere you turn. From upcoding to denials, the huge and growing program—which now covers more lives than traditional Medicare, but is increasingly the target of local and federal scrutiny and a stream of endless OIG audit reports—seems to be in the news daily.   In a…

Listen to the complete episode here.    Here we are, at the end of the year. And the end of another season of Off the Record.   For reasons that will soon become clear, I wanted to wrap up 2024 by pushing myself out of my comfort zone. Because this episode is about personal growth.…

By Brian Murphy   Machines are a human augmenter—not a human replacement.   I love the way my recent Off the Record podcast guest Rhoda Chism frames technology in her CDI practice. As an amplifier, extending her reach and allowing her to touch more patients, but not a substitute for her unique skillset.   Two…

Listen to the episode here.   Last month I wrote a post about the four stages of a career, using the analogy of seasons. I was inspired by the wonderful fall weather I was experiencing while on a walk here in New England, but also by changes I have been experiencing in my life and…

Between MS-DRGs, HCCs, U.S. News and World Report rankings, Leapfrog, readmissions, mortalities, Vizient or Premier performance, and on and on, how does a CDI program know where to focus its record reviews? The choices seem bewildering.   My current guest on Off the Record Leif Laframboise has settled on present on admission (POA) as the…

Listen to the complete episode here.   With 23 years and counting in CDI, Rhoda Chism has seen a lot. The rise of new regulations and reimbursement mechanisms, and the advent of new technologies that have radically transformed chart reviews.   Rhoda has not only weathered these changes and navigated the turbulent waters, but remains…

Listen to the program here.   Karen Elmore is living in denial(s).    Her job as Senior Clinical Documentation Quality Coordinator for BJC Healthcare involves a daily battle against a never-ending tide: Payers denying diagnoses on the perceived basis of lack of clinical support. Recently she’s had to deal not only with human payers, but…

Listen to the recording here: https://spotifyanchor-web.app.link/e/HvfKYIDsKNb  We’re happy to bring you part 2 of our interview with Revka Stearns, who joined us on Off the Record to provide an update of her first eight months on the job as a new inpatient coder. If you haven’t listened to part 1 I’d recommend starting there, since…

By Brian Murphy   Establishing facilitywide diagnosis definitions is the gold standard for many organizations. If providers and the CDI/coding team agree on what constitutes postoperative respiratory failure for example, clinical disagreements should be greatly reduced, the need for queries lessened, and coding accuracy improved.   Unfortunately, payers also (appear) to have the same leeway…

Listen to the episode here: https://spotifyanchor-web.app.link/e/EBiWUwjOmNb Back in January I hosted newly minted medical coder Revka Stearns. For someone so new to the industry, Revka has made a big impact by the act of sharing–documenting her journey in detailed and open fashion on LinkedIn and Facebook, and a half dozen podcasts and programs. At the…