Guest post from Alice Zentner, Director of Auditing and Education for TrustHCS:
Many providers have CDI programs. The belief is that more accurate, detailed clinical documentation is better for the patient, the institution, the government, researchers, and all aspects of quality of care. So why not have an improvement program for the improvement program?
Too many CDI programs focus on the short-term goals of reduced denials and fewer queries only for those DRGs and types of cases payers are reviewing today. But a truly visionary CDI program takes a much longer-term view of both the areas for documentation improvement and the ability for programs to achieve a return on investment.
Certainly, CDI programs should focus on current areas of weakness that are impacting cash flow, but with a focus on the longer-term goals; like successfully implementing ICD-10 and building the framework for strong documentation practices that will support future upgrades to coding systems.Quality initiatives and pay for performance seem to be gaining traction as healthcare initiatives, which would also benefit from better, more accurate documentation. Looking forward to incorporate these programs into today’s CDI initiatives gives providers time for a methodical, transition to any new reimbursement model – not to mention solid quality data and business intelligence to make better, long-term decisions.
Trying to jam change into the last minute is a formula for mediocrity. You get done the absolute minimum needed to meet a program’s needs but you never reap the upside benefits that these programs present.
Your CDI initiative is a living process that should be proactive to future needs, not reactive. Preventative medicine is always preferred to illness intervention. Make sure your CDI program has an oversight group charged with improving the improvement program. While ICD-10 and the many other initiatives in healthcare seem to be overwhelming, a successful CDI program can greatly smooth the road to change.
About Alice Zentner, RHIA
Alice is the Director of Auditing and Education for TrustHCS. She brings over 21 years of health information experience primarily focusing on coding audits, education and billing follow-through. Throughout her extensive career, Alice has also served in clinical documentation improvement (CDI) roles as a concurrent review coding specialist and CDI consultant with national healthcare consulting organizations. Prior to consulting, Alice served as interim coding manager, director of education and outpatient coding services and as a nurse auditor/revenue integrity officer for a large HCA teaching facility.
In her current role as a Director of Auditing and Education, Alice will assist TrustHCS’s team of auditors as well as conduct ICD-10-CM/PCS preparedness assessments, planning and audits for clients. Alice is also leading TrustHCS’s education initiatives for all clinical specialties while building collaboration between CDI specialists and clinical coders.