“In the hospital setting, we see multiple insurance denials on a weekly basis,” Lamon Willis recently wrote in an article for ICD10monitor.
“Teams of people route them to various departments for analysis and review. I have staff members who review the APC and/or DRG, along with coding criteria, to determine if we have properly fulfilled our duties as coders and to support the appeals process for the organization,” he continued. “My staff and I agree on one thing at the very beginning, and that is: don’t believe the denial.”
During this edition of Talk Ten Tuesdays, Willis, director of coding for Velocity Healthcare Collaborative, explains valid reasons for not necessarily believing in DRG denials by auditors.
The live broadcast will also feature these other segments:
- The Coding Report: Laurie Johnson, a senior healthcare consultant at Revenue Cycle Solutions, LLC, continues her exclusive reporting on the coding of e-cigarette lung injuries (vaping).
- Tuesday Focus: Nationally recognized professional physician coder and auditor Terry Fletcher, a member of the ICD10monitor editorial board, reports how physicians and providers could have their Medicare enrollment revoked if they are affiliated with an organization directly or indirectly that has any history of "bad acts" with the program.
- Five Looking at Ten: Deborah Grider, author, educator, and senior healthcare consultant for Karen Zupko and Associates, returns to the broadcast to report on coding lessons learned in ICD-10.
- Five Looking at Ten: The WEDI Role: Stanley Nachimson reports on the role played by the Workgroup for Electronic Data Interchange (WEDI) in the run-up to ICD-10. Nachimson led the WEDI ICD-10 Implementation Timeline Initiative and co-chaired the ICD-10 Testing workgroup.
- News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.