Complacency is the main contributing factor that leads to suboptimal performance and achievement of sustainable operational processes and outcomes for any business. Clinical documentation improvement programs have discounted the necessity to evolve with the times, overlooking critical opportunities to contribute to the overall welfare of the healthcare delivery model. A strong CDI program for the right reasons with an underlying commitment to achieving

As outlined in the 2019 Medicare Fee-For-Service Supplemental Improper Payment Data Report, the overall Medicare Improper Payment Rate was pegged at 7.3% translating into $28.91 billion paid to providers improperly. This is a marked improvement from 2018 when the improper payment rate was 8.1% which represented $31.62 billion. The bulk of those improper payments paid by Medicare in 2019, similar to 2018, were attributable to two related

What many CFOs are being told: “Clinical validation denials and DRG downgrades are the result of egregious, overaggressive payers who ignore official coding guidelines and arbitrarily challenge diagnoses like sepsis, acute respiratory failure, and metabolic encephalopathy.”

Listen to Glenn cover various points in the CDI arena. You can check out the website this podcast is featured on here.

Palmetto GBA just this week posted on its website an article titled Hospital Readmission Without Septicema discussing the CMS Hospital Readmission Reduction Program. pointing out the cost of unplanned readmissions is $15 to $20 billion annually. Interesting enough the following statements in the article run contrary to findings of a study published in January’s Health Affairs

Unfortunately, they don’t teach you how to run a business in medical school. As a result, many physicians struggle to manage the business side of their practice. Entrepreneurial skills are essential if you want your practice to thrive! Are you looking for ways to improve your practice and take your business to the next level? Below, Core CDI shares some tips to help you build a more profitable practice and improve patient satisfaction.

Most Clinical Documentation Integrity (CDI) programs are mislabeled and misidentified in the present format. Integrity is defined as the quality or state of being complete or undivided per Merriam-Webster. A few years back the association representing the Clinical Documentation Improvement Specialist’s community elected to replace the “Improvement” part of the name to “Integrity”, now referred to as Clinical Documentation Integrity Specialists.

Clinical documentation integrity programs have evolved over time with its expansion of duties and responsibilities beyond CC/MCC diagnosis capture. The profession has expanded its reach into quality measures such as Hospital Acquired Conditions, Patient Safety Indicators, Core Measures, and other documentation driven reportable measures of care. Fundamental to operational performance of any clinical documentation integrity program is enhancing the physician’s

Most Clinical Documentation Integrity (CDI) programs are mislabeled and misidentified in the present format. Integrity is defined as the quality or state of being complete or undivided per Merriam-Webster. A few years back the association representing the Clinical Documentation Improvement Specialist’s community elected to replace the “Improvement” part of the name to “Integrity”, now referred to as Clinical Documentation Integrity Specialists.

CDI programs have strong potential to significantly raise compliance risks for the hospital or health system in which the program operates. Compliance departments strive to minimize and alleviate the numerous risks associated with the myriad of components associated with and fundamental to the delivery of healthcare. Clinical documentation improvement initiatives can work in tandem, align and collaborate with the compliance department’s goals and objectives,