Author Archives: Brenda Palumbo

Outpatient and Quality: Where can CDI and Coding make an impact?

Clinical Documentation Improvement (CDI) – The shift to Outpatient and Quality: Where can CDI and Coding make an impact? Over the last several years there has been a steady shift in focus from traditional inpatient clinical documentation improvement (CDI) programs towards outpatient CDI and Quality Improvement programs. This shift is...

Maximize Compliance and Revenue with Provident

Complimentary Review of 30 Inpatient Records Provident understands the financial pressure hospital organizations across the country are feeling due to increased regulation and shifts in reimbursement methodologies. Every dollar is crucial.  Provident’s Revenue Integrity Audit methodology can help by maximizing revenue capture in a compliant manner.  With years of proven results...

Medicare Cost Report: What is it?

All Medicare certified institutional providers are required file an annual cost report to their respective Medicare Administrative Contract (“MAC”). But what is a Medicare cost report and what is the process for submitting and finalizing one? The Medicare cost report is comprised of a series of worksheets and schedules that...

mHealth: Security Considerations

According to Mobile Advertising Forecasts 2016 75% of all global internet use in 2017 will be conducted on a mobile device, an increase of 35% in just five years.  By the end of 2018, mobile devices will account for over 1 out of every 4 U.S. e-retail dollars.  The trend is...

CMS Seeks Input for Consideration in Future Rulemaking

Request for Information On April 14, 2017, the Centers for Medicare & Medicaid Services (“CMS”) issued the 2018 Inpatient Prospective Payment System (“IPPS”) proposed rule including a Request for Information (“RFI”).  The overarching message from CMS is to seek comments to the proposed rule and through the RFI that will...

Guidance on How It Determines the Effectiveness of a Compliance Program

The Department of Justice Issues Guidance on How It Determines the Effectiveness of a Compliance Program Recently, the Department of Justice’s (“DOJ”) Fraud Section released guidance entitled “Evaluation of Corporate Compliance Programs,” (“Compliance Memorandum”), which highlights how federal prosecutors investigate the adequacy of an organization’s compliance program during a criminal investigation....

Coding and Documentation Compliance Series

Provident’s Coding and Documentation Compliance Series featured three (3) webinars focused on documentation standards, coding best practices and ways to ensure inpatient hospital based reimbursement aligns with the care being provided. The third webinar in the series, ICD-10 DRG Audit Target Areas includes the following case studies: o Sepsis o...

2017 ICD-10 DRG Audit Target Areas: Sepsis

Provident has been engaged in ongoing DRG audits since the implementation of ICD-10 in October 2015. We have identified potential DRG audit target areas related to our audit work, changes to the ICD-10 codeset, and Coding Clinic updates. We will be posting target area case summaries with suggested audit strategies...

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