Successfully Appealing Clinical Validation Denials for Sepsis

It’s been almost two years since The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) was published. How has the new definition impacted payer behavior regarding audits, denials, and appeals?

Join us as we share what we’ve learned over the years from appealing hundreds of clinical validation denials for sepsis on behalf of our hospital clients. We will discuss SIRS with infection versus Sepsis – 3 criteria and whether the different definitions even matter. We’ll reveal payer behaviors regarding auditing and denying this diagnosis code. And, as always, we will share proven, successful appeal strategies that you can use right away.

Learning Objectives:

  • Understand the difference between SIRS and Sepsis – 3 criteria
  • Understand payer behaviors regarding clinical validation audits for sepsis
  • Discover successful strategies to compose winning appeals when the sepsis diagnosis is denied, even though you got it right