Calendar

Wednesday, December 16 2015 • 2:00 PM – 3:00 PM EST

Join Denise Wilson, MS, RN, RRT, from Intersect Healthcare + AppealMasters, and guest panelist James Haering, DO, SFHM, from Resonant Physician Advisory Services as they focus on the current state of audits related to diagnosis validation and provide resources available to monitor, review, and audit activity in acute care.

This presentation will define key terms related to diagnosis validation and examine the common documentation issues that impact audit risk. It will discuss the steps for improving the validity of diagnosis and documentation requirements and information needed to meet standards for medical necessity and stand up to audit scrutiny. Diagnosis validation appeal strategies will be discussed through the use of actual case studies.

Learning Objectives:
• Define key terms related to Diagnosis Validation (DRG) and review current state and identify services under audit focus
• Understand common documentation pitfalls that impact audit risk
• Amplify current coding documentation improvement (CDI) efforts to include components of regulatory audit focus
• Discuss the steps for improving the validity of diagnosis
• Understand appeal strategies through the use of case studies

About your presenters

Denise Wilson MS, RN, RRT

VP of Clinical Services, Denial Research Group

Denise serves as Vice President, Clinical Services, Training and Education for AppealMasters, the appeal service group of the Intersect Healthcare family. With over thirty years of experience in healthcare, including clinical management, education, compliance, audit, and denials, Denise has educated thousands of healthcare professionals across the country on the art and science of writing winning appeals.

James Haering, DO, SFHM

Hospitalist, Sound Physicians
Physician Advisor, Resonant Physician Advisory Services
Dr. Haering is a practicing hospitalist with Sound Physicians with 20+ years of clinical practice. He’s served as Medical Director of Clinical Documentation, Physician Advisor for Utilization Review and Hospitalist Director at a Midwest multi-hospital health system. Dr. Haering continues involvement with transitions of care projects with Medicare, BCBS and the Society of Hospital Medicine (SHM) and serves on SHM’s Post-Acute Care Taskforce. He provides education on documentation and transitions of care.