Case Management

Case management Q&A

Case Management Weekly, November 14, 2012

Q. Why is documentation important? 

A. Documentation by the medical staff is one of the pillars that lead to reimbursement success. It can be argued that documentation is the singular issue in denials. Most physicians and their extenders are not trained to think in terms of denial prevention, but rather in terms of how to document findings, symptoms and signs, and the plan of care. Physicians and their extenders should receive training that explains how documenting the true nature of acute episodes can prevent denials. Proper documentation provides evidence of medical necessity. 

Editor’s note: This Q&A is adapted from Prevent Denials and Win Appeals: The Hospital Case Manager’s Guide to Revenue Integrity published by HCPro, Inc.

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