Now that ACDIS Annual National Conference has concluded, this is an excellent time to revisit and potentially revise and revamp our current clinical documentation improvement initiatives. Clinical documentation improvement, while considered a service business, is quite similar to most other product lines in the sense of finite and distinct end point life cycles. Take automobile […]
CDI-Tremendous Unrealized Potential
Clinical documentation improvement programs can potentially serve a wide array of beneficiary purposes besides improving revenue capture and optimization if offered the opportunity. Present initiatives at documentation specificity, while inarguably important and valid under ICD-10 processes, are primary limited to basically scratching the surface when compared to the tremendous unrealized potential we as […]
Clinical Bundles
Bundles of care exist for serious disease processes with tendencies toward greater mortality rates such as sepsis. These bundles consists of standard checklists of care interventions that have demonstrated increased efficacy in overall treatments that are cost effective, efficient, drive notable decreases in morbidity and mortality while improving the cost and value equation of […]
The term “Clinical Documentation Improvement” is synonymous with impacting case mix index and CC/MCC capture clinical specificity. Does Clinical Documentation Improvement equate to achievement of effective clinical documentation. Are the terms synonymous, mutually exclusive or synergistic in nature?
Clinical documentation improvement specialists should be striving to achieve in each and every chart we review complete, accurate […]
Healthcare delivery is a challenging environment with an unlimited number of competing forces working against providers. A major challenge of all providers is insuring an efficient and effective revenue cycle process that incorporates a strong clinical documentation, coding and billing process that can withstand the pressures of third party payers relentlessly second guessing the clinical […]
Insufficient medical record documentation is pervasive in the medical community regardless of healthcare setting or clinician. This environment of persistent insufficiency in clinical documentation exists for a variety of reasons, a major contributing factor being the increased use of the electronic health record mandated by Medicare under meaningful use. The electronic health record’s current structure […]