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Financial success of Comprehensive Care for Joint Replacement (CJR) model paved way for TEAM

By Brian Murphy   The Comprehensive Care for Joint Replacement (CJR) model is over, and it generated savings to Medicare. How much? We await the…

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New Norwood special report examines latest trends in payer denials

Download the report here. Denials are being turned up, not down. But they’re happening in less noticeable and more insidious ways, often under a different…

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You need to have it both ways: Audits must target missed coding opportunities and invalid conditions in risk adjustment

By Brian Murphy Among the alleged behaviors that led to Kaiser’s eventual $556M payout to settle false claims act allegations was its aggressive effort to…

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Five things to know about Present on Admission (POA) for hospital payment, quality

By Brian Murphy Present on admission (herein POA) for coding purposes is defined as conditions that are present at the time the order for the…

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How a baseline became a springboard to documentation, coding improvement

What gets measured, gets managed. An old business truth … but we don’t always think of the inverse.  Without a baseline, you won’t know where to focus.  An integrated healthcare system comprised of county-owned hospitals and clinics suspected…

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