Moving in the Right Direction in Addressing Current CDI Shortfalls- Strengthening Overall Revenue Cycle Processes through Proper Repositioning
10:00 AM PDT | 01:00 PM EDT
By attending this highly informative session, attendees will learn how to complete an assessment of their facility's current CDI processes, identify strengths, weaknesses, threats and opportunities to be used as the basis for reformulating, rebranding, reengineering and repositioning CDI foundations and processes to best support achievement and reporting of quality of care outcomes while aligning, integrating, strengthening and supporting the hospital's revenue cycle performance.
Overview:
Current CDI programs potentially increase compliance risk as well risks of financial recoupments and takebacks associated with attempts to improve documentation through the query process.
Overemphasis is placed upon the query process as the primary means of improving clinical documentation with increasing use of software to prioritize and enhance efficiency in CDI specialist chart review.
Reviewing more charts and issuing more queries exponentially increases compliance risk and significantly detracts from the integrity and performance of the revenue cycle through exposure to prepayment and postpayment third party payer reviews and denials.
By attending this highly informative session, attendees will learn how to complete an assessment of their facility's current CDI processes, identify strengths, weaknesses, threats and opportunities to be used as the basis for reformulating, rebranding, reengineering and repositioning CDI foundations and processes to best support achievement and reporting of quality of care outcomes while aligning, integrating, strengthening and supporting the hospital's revenue cycle performance.
Why should you Attend:
CDI programs in their present format have the real potential to significantly increase compliance concerns and be a real drag on the revenue cycle by increasing outlier risk, financial recoupments and denials.
Cost to collect in the revenue cycle rises in tandem with increasing number of queries issued as third-party payers refute billed claims on the basis of medical necessity and clinical validation.
CDI programs also heighten compliance risk through potentially aberrant coding and billing patters identified by the OIG, Recovery Auditors, Medicare Administrative Contractors, CERT Contractors, PEPPER reports as well as commercial payers and their cost containment contractors. CDI programs if not positioned properly can accomplish serious disservice to the hospital's financial position causing undisputable financial harm and repercussions.
Hospitals and health systems must take a close look and rebrand, redesign and repurpose current CDI programs to address known shortcomings and shore up alignment and integration with the revenue cycle and the accurate reflection, capture and reporting of patient care provided and true achieved quality.
Areas Covered in the Session:
- Identify, Compare and Contrast current CDI programs versus ideal components of a "best practice" program
- How and why do CDI programs exponentially increase compliance risk and medical necessity/clinical validation denials
- What are the basic foundations and operational processes required to strengthen CDI program and bring them in line with revenue cycle processes and overall financial performance of the hospital
- How to redesign and reposition CDI programs to drive down unnecessary denials through appropriate planning, inventory assessment and alignment with all relevant healthcare stakeholders
- Implement a continuous quality improvement feedback loop to continually strengthen and improve program outcomes while reducing compliance and financial risk
Who Will Benefit:
- VP Revenue Cycle
- COOs
- CFOs
- Revenue Cycle Managers
- Revenue Cycle Directors
- CDI Directors
- CDI Managers
- CDI Specialists
- Patient Financial Service Directors
- PFS Managers
- HIM Directors
- HIM Managers
- Denials and Appeals Staff
Speaker Profile
He possesses twenty-five plus years of progressive practical hands on experience in clinical coding and documentation improvement, subscribing to the philosophy that quality of medical record documentation strongly correlates with overall quality of care achieved and the overall achievement of a high performing revenue cycle. Glenn has demonstrated the unique skill sets and core knowledge of principles and standards in best practices of clinical documentation, effectively and successfully driving physician engagement through proven strategies that create and foster a sustainable model for clinical documentation improvement.
What sets Glenn apart in the clinical documentation improvement arena is the recognition of clinical documentation effectiveness, accuracy, completeness and contextual consistency as fundamentally integral and intertwined with all components of the revenue cycle. He is a professional speaker, sought after for speaking engagements throughout the country on a wide variety of cutting edge thought provocative clinical documentation improvement topics and subjects.
Glenn has served on the ACDIS Advisory Board as well as founded the WI ACDIS Chapter, leading a very active chapter for six years. The inspiration for creation of Core-CDI was the goal of creating a forum for sharing thought provocative ideas and concepts on all things CDI including an awareness of the opportunity to transform the profession of CDI to one that truly supports the patient and the overall healthcare delivery model.