What’s in your EHR?

Why does my medical record not contain everything that happened to me during my stay? Why does this version of my record not look like the previous version that you provided to my lawyer? Why does the record you gave me last month look completely different from the record you gave me last week? Why […]

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To Simple Visit Code, or Not?

Do you ever wonder how you could decrease your coders’ workloads? Have you heard other organizations talk about simple visit coding accounts? Or do you simply wish there was a way to automatically code basic visits? At The Wilshire Group, we have HIM consultants with years worth of experience implementing simple visit coding (SVC). Consideration […]

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The (Never-Ending) Battle on Denials

Denials have always been an uphill battle. As soon as you think you have a handle on one facet of it, the payer throws another unexpected change at your organization. Regardless of how strong your reporting, staff, and approach is with denials, they aren’t 100 percent avoidable. I came across a great article, “Staying One Step […]

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Revenue Integrity 101

“Revenue Integrity” within a healthcare system means many different things depending on who you ask, the size of the institution, and if the OIG (Office of Inspector General) has paid a visit or not. I believe Revenue Integrity (RI) is a culture that lives within an organization and is part of each component of the […]

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ICD-10 Readiness Checklist

67, 66, 65, 64 days and counting…. We are officially on the FINAL countdown to ICD-10 implementation. Health systems, providers, payors, etc., are working diligently to review that “Master Task List” we all created, what seems to be, a decade ago by now. At this point, time is short and some in the healthcare industry […]

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Code Integration

Most organizations produce 1,000s of claims a day with hopes they’re compliant and will ensure proper reimbursement. Within those UBs/837Is are claim lines, which are primarily comprised of charging and coding data. The process responsible for creating those claim lines is “Code Integration.” At most organizations, this process is a black box. It happens behind […]

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Combination Code Support by CDI

As we continue our journey towards ICD-10 implementation on October 1, 2015, the use of combination codes brought up a discussion between myself and another CDS (Clinical Documentation Specialists). I had just read this  article , and we were doing some chart review and code capture in ICD-10, when we saw the combo code that was […]

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