Compliance is one word that holds a lot of weight when it comes to healthcare data analytics, data segregation and basically anything that has a remote link to the world of patient care and information management. And quite valid to be so. When you ask hospitals CFOs and the leadership or Administration teams, the consensus rises very clear. One of the top five reasons hospitals choose to implement a new CDI software or even upgrade an existing CDI software is that of ensuring that all medical data, patient information and other legal notes are secured and that the use of these is within the boundaries of essential compliance.
Quite naturally so, CDI programs are fast becoming the pioneers of compliance efforts in most organizations. And it is generally advisable for hospitals to keep their compliance officers and legal teams in the loop during, after and through the entire implementation timeline. Inputs from these teams can go a long way in ascertaining that the CDI program you have chosen matches the compliance regulations of your hospital.
As a quick tip, remember that at any given point, your typical CDI program should:
1. Make correct documentation a mandate to support admissions, readmissions, continued patient care as well as enlist procedures and treatments made during the entire period
2. Establish a continuum between coding, reimbursement, Case Mix Index (CMI) accuracy and audits
One of the overarching roles that a CDI program plays is that of facilitating a real time and complete representation of all your health care services. When your CDI is successful the impact can be clearly seen on your daily routines including admissions, pay for performances as well as centers for Medicare and Medicaid Services’ quality. CDI lets you improve your documentation, reduce compliance risks, and minimize your facility’s vulnerability to third party audits.
The end goal of a typical CDI program is to improve the quality and completeness of medical records, loop any gaps and content irregularities and bring about a certain accuracy in the way disease severity, risk and patient mortality rates are configured.
One of the features of a CDI process is conducting concurrent reviews of patient health records. Depending on the relationship between your CDI and your HIM, the CDI staff may communicate and share patient records to HIM following the patient discharge. In some cases, they may also follow up on information gaps and close them before the final billing begins.
Some CDI programs are also programmed for a reverse review thus decreasing the dependency on the HIMs for the same. Regardless of when the reviews are conducted, the end aim is always to clarify upon and complete documentation that is conflicting or incomplete. Your typical CDI professional will work to facilitate enhancing the quality and completeness of clinical documentation to detail case severity and risk of mortality of the patient being treated.
When the data comes in clean, when the records are accurate and have no information gaps, when the patient records are complete and accurate, the billing is efficient. When the billing is efficient, your DNFB days are automatically reduced, your data discrepancy is sorted, the audits are smooth and glitch free, your CMI is at a pleasant level and your compliance levels are where they should be.
Do you have a good CDI in place? Would you like to get one? Visit us at www.ezDI.com to know more.