Medical Necessity and Paid Claims: What Do They Have To Do with Clinical Validation and Health Informatics?












By Donna Young, RHIA, CDIP, CCS; Okemena Ewoterai, BSN, MA, CCS, CCDS, CDIP; and Katherine Lusk, MHSM, RHIA, FAHIMA


As support for the value-based payment arena grows, payer audits are increasing. Payment can be denied based upon a....