The key shift of focus from ICD-9 to ICD-10 is on specificity of coding. For a medical coder to be accurate in ICD-10 coding, the provider should include specific details of the diagnosis or procedure during the documentation stage. Because providers are not trained in medical coding and often prefer to type less while using an EHR, they omit certain important details and won’t give the coder enough information about the diagnosis/procedure. For example, when a provider documents a diagnosis as “Eyelid retraction” vs “Eyelid retraction, right upper eyelid” it helps the coder to code more accurately under the ICD-10 guidelines. Understanding and addressing the root cause of poor clinical documentation is critical to patient record accuracy, clinical care, and revenue cycle success. Our CDI program adds value to the overall revenue cycle management with the help of certified and industry leading CDI experts. Our CDI team carefully examines the documentation and effectively engages providers for a patient-specific conversation and educate them the changes needed in their documentation style. We do this with a consistent focus until the providers are sensitive about the changes needed in their documentation, yielding more accurate reporting and higher revenue, both with proven numbers.
Our CDI program will help you reduce revenue loss by optimizing reimbursements. This is done through a combination of expert consulting, physician education, and auditing services. Some of the highlights of our CDI Program include:
Improved Physician Documentation: We significantly improve physician documentation by engaging them in meaningful discussions and educate them on what specific changes are needed in their documentation capture habits. We support and track this process with physician scorecards and profiling data until the desired results are achieved.
Concurrent Reviews: We believe that claim submissions have to be honored by the payers the very first time those are submitted and our CDI strategy always ensures that the on-going documentation is accurate enough to avoid a denial in majority of cases when submitted.
Highest Case Mix Index (CMI): Our CDI programs always focusses on improving the Case Mix Index of your facility by carefully analyzing each case to validate if the individual DRG allocations are accurate.