Legal eagle: Healthcare denials through the eyes of Sarah Mendiola

Denials are a reality of life in the mid-revenue cycle. And they’re not going anywhere. As Medicare Advantage (MA) grows—MA Organizations statistically deny more care than traditional Medicare—the volume of denied claims will only keep growing. I wanted to talk about this subject with someone who not only understands the current mine-filled landscape, but knows…

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Boston strong: Climbing the U.S. News and World Report Best Hospitals rankings with CDI Director Deb Jones

Since taking on the CDI director role at Brigham at Women’s Hospital in October 2017, Deb Jones has made big changes with big impact. These include:   A deep focus on risk adjustment and mortality reviews. Boston is an incredibly competitive healthcare environment with 25 hospitals operating within the city. Patients have a choice of…

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“You need to have a vision”: A conversation with Adelaide LaRosa, VP of HIM, CDI, EMPI, and DRG Appeals, Catholic Health

off the record

You’ll find few CDI/coding personalities as big and colorful as Adelaide LaRosa—and fewer still with a broader and bolder vision for what mid-revenue cycle professionals can do, and should do, to improve the quality and financial health of their organizations. Catholic Health’s VP of HIM, CDI, EMPI, and DRG Appeals reordered the entire heart of…

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2022 in review, 2023 look ahead—and a whole lot in between

off the record

For our final episode of 2022 we’re going off the record (even for Off the Record) with a couple interesting guests you may recognize from Brian’s home base at Norwood. This week we’re joined by CEO and Founder Justin Satterfield, and VP of Consulting Jason Jobes. As you might expect at the holidays the conversation…

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