CDI in Denials Management

kvquillkvquill
in CDI Expansion

Hello all,

I've been very interested in piloting a CDI in Denials Management program at my organization. I have all the statistics on the benefit of such a program and probable ROI, but am looking to connect with anyone who has had actual experience in establishing or supporting a similar program. Any input on program structure, benefits, drawbacks, ROI, education, or other impact would be extremely beneficial. If you are comfortable doing so, please include your contact info so that we could talk further.

Thanks so much!!

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Comments

  • cynthia.mead@nahealth.comcynthia.mead@nahealth.com

    HI,

    I have been managing our clinical indicator denials for several years now and am happy to share what we have done.

    Our day to day team consists of myself, a Coder 3 and an insurance specialist.

    The insurance specialist receives the denials, enters them in our tracking system where they are reviewed by myself and/or our Coder. We decide to accept, appeal or refer to our physics advisor.

    We also have the benefit of an analyst who helps us show the value we add to the organization.

    I'm happy to discuss what we do, you can either email me or give me a call. (I'm off work till 4/23)

    Cynthia Mead RN CCDS

    Cynthia.mead@nahealth.com

    928-773-2374

  • kvquillkvquill

    Thank you for the reply, Cynthia! I tried calling you and sending an email. I hope to hear from you soon. I'm very interested in your input!

  • cynthia.mead@nahealth.comcynthia.mead@nahealth.com

    kvquill I don't see an email from you, please try again or post your contact info  here and I'll get back to you.

    Cynthia

  • kvquillkvquill

    Hi Cynthia,

    I'll try resending, but you can reach me anytime this weekend at kvquill@gmail.com or at the following number:

    928-412-7652

    Thanks!

  • ojaff12ojaff12

    I am in charge of both CDI program and denials management at my hospital, we are currently discussing taking over some UM/medical necessity review roles. Would love to network and discuss.

  • tpeyton1tpeyton1

    Our CDI program developed a denials management role for clinical denials that was very effective -  There is a book out by AHIMA about denials management that gives some steps on implementing the process.

    I hope this will help you in your efforts.

    Terry Peyton, RN, CCDS

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