Rising Dispute: Clinical Validation Audits
About this episode
This episode discusses the rise and implications of clinical validation audits in healthcare.
The rise of third-party payer audits is no secret to healthcare professionals and facilities, but one type of audit has gained particular attention in recent years: the clinical validation audit. Clinical validation audits ultimately lead to a downgrade of a hospital’s diagnostic-related group (DRG) payment, but the process by which they reach that result makes them particularly curious. During utilization review, health plans make decisions about the patient’s care and, in the ca...
More episodes of Talk Ten Tuesdays
- ACDIS-AHIMA Proposed Practice Brief: Comment Period Now Open
- LIVE from ACDIS, James S. Kennedy MD: Analysis of the 2027 IPPS Proposed Rule
- Tips to Protect Revenue in the Face of OIG Oversight
- Outpatient CDI: Protecting Risk Adjustment in a Time of Intensified OIG Oversight
- Clinically Correct, but Legally Risky
- Yet Another Data Breach
Explore listener stats, chart rankings, contacts and more on the Talk Ten Tuesdays podcast page.