2020 has been a challenge for everyone. CDI teams took heavy hits industry wide as surgeries were cancelled and censuses fell to all-time lows. We all have a new reality, social distancing, remote staff, and continued census fluctuation. Some have even experienced reallocation of team members back to patient care roles when necessity called.
These are trying times for all of us. In this time of rebuilding, your recovery process can benefit from pouring into your CDI efforts.
Here are some of the key areas to consider as you rebuild.
CDI Remote Staff Augmentation
Clear, concise documentation has never been more important than now. Current encounters need to be thoroughly reviewed for an accurate depiction of the stay, patient’s severity of illness and risk of mortality and medical necessity. It has never been more important to ensure diagnoses are clear and that the treatment rendered was warranted. Remote CDI Staff can help fill the gaps that your current program may have due to loss of personnel or overwhelming review volumes.
Audits serve many purposes, they show areas of opportunity for CDI, coders, and providers. They also highlight potential financial gains and risks. Consideration of a pre-bill audit allows you to have an assessment of your facility’s work, in real time, allowing corrections, queries, and education to be provided in a timely fashion. This timeliness creates a strong potential return on investment.
Prebill audits also serve to migrate risk. With provider workload significantly increased and the number of CDI to review charts decreased, a prebill audit can help substantiate diagnoses and clinical validity. This will be more important than ever in the months to come. Accurate charts make for denial protection in the future, it is much easier to get things correct upfront end then try to overturn them on the backend.
As payor and government audits ramp up again, and bandwidths already stretched due to staff changes, the appeal review and letter writing process may be difficult to cover. Trained CDI professionals can assist in the chart review and letter writing components for the denials you receive. Too often denials are lost simply because the staff needed to appeal them are not available. Supplemental CDI professionals can help defend your providers documentation by providing this additional support.
Every CDI program has room to grow, whether in evaluating current processes or creating new ones, expanding to additional payors or patient care settings. Change is never easy, but it can be necessary.
A “Gap Analysis” reviews your current state and evaluates where changes can be made to take your program to the next level. A solid Gap Analysis should review current policy and procedures, workflow process, compliance integrity and patient population coverage to help you achieve your goals. These Gap Analyses are applicable whether you wish to establish a CDI program or revitalize a program that is new or was established years ago.
Boot Camp Education
CDI and coding are ever changing and ensuring staff have the most up to date education is essential for program success. Boot camps for these team members help boost individuals that are brand new to the world of CDI. These same boot camps can also focus on those looking to advance their practice by becoming familiar with additional disease processes and query opportunities. A proper boot camp can be delivered successfully in a remote environment and can provide “leave-behind” materials your team can reference in their daily operations.
New Initiatives & Program Expansion
2020 has allowed many CDI programs to evaluate current state and exam what next steps may look like. CDI programs are answering the questions:
- “Is this the time for us to move from IP only reviews to OP?”
- “Are HCC initiatives in the provider setting or medical necessity reviews in the ED next for our team?”
- “Are clinical validations a concern and a focus that we want to pursue?”
Turning to experts that can assist in programmatic development of new focused initiatives like those stated above is critical during this rebuilding process.
We will never be able to make up for the losses suffered in the first half of 2020, but we can optimize the present. Clear and concise documentation translates to quality for our patients, quality reporting, and quality for our facilities.
If any of these areas are of value to your CDI program, contact TrustHCS today at www.trusthcs.com/contact. We can help.