This session was recorded on Friday, February 28, 2014.
Using Criteria Tools to Reduce Denials
Dr. Bill Rifkin Demonstrates How To Use MCG for more than Admissions
Bill Rifkin M.D., FACP, FHM, Managing Editor at MCG (formerly Milliman Care Guidelines) gave a demonstration of how the proper and savvy use of MCG content can help reduce audit risk and denials by helping clinicians in determining the following:
a. Appropriate care of patient (eg, level of care)
b. Appropriate documentation to support clinical decisions (re: payment submission)
c. Inform/help length of stay expectation assessment and documentation
d. Understanding how Goal Length of Stay (GLOS) for a given guideline/condition does or does not impact level of care determination, length of stay expectation assessment
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