Join MedReview in Dallas Nov. 6-9 at the NHCAA Annual Training Conference
Finding savings bigger than Texas
MedReview’s donning cowboy boots and heading south to find savings bigger than Texas at the National Health Care Anti-Fraud Association (NHCAA) Annual Training Conference (ATC).
November 6-9, the team will be in Dallas to speak with industry executives about uncovering and preventing healthcare FWA.
Visit us at Booth #301 to learn how our meticulous clinical validation process and other payment integrity solutions have saved health plans billions, while tasting a variety of tequila pairings.
On November 7, don’t miss Chief Medical Officer Dr. Michael Menen’s presentation on one of the most frequently coded DRGs–sepsis–and how its changing definitions have resulted in DRGs that often do not match the clinical record. Attendees of the session will receive an AAPC CEU toward their designation(s).
Presentation: A Historical Perspective of the Most Common DRG
Date/Time: Tues., November 7, 2023 | 3:30-4:30 PM CST
Location: Reunion Ballroom BC
Presenter: Michael Menen, MD, Chief Medical Officer, MedReview Inc.
Evolving, and controversial, definitions and interpretations of sepsis have led to the development of complex coding systems that attempt to capture the severity of sepsis. Sepsis is one of the most frequently coded DRGs, and one of the most expensive. Much effort has gone into promoting the appropriate detection and treatment of sepsis, yet there is a high rate of overdiagnosis. This has led to a high volume of sepsis diagnoses that do not seem supported by the patient’s clinical course or the resources used to care for the patient. This presentation explores our understanding of sepsis. We explore how our current understanding of sepsis has resulted in coding challenges. We will dive into how these challenges can be reconciled using clinical validation and claims review and will present a variety of case studies that illustrate how we can protect against inappropriate coding and expense.
To schedule a meeting with MedReview at NHCAA, click below.