What is Value-Based CDI?

By Brian Murphy Value-based healthcare is a delivery model in which providers (i.e., hospitals and physicians) are rewarded for the quality of care they provide. It is perhaps easiest to understand when contrasted with traditional fee-for-service delivery models. Fee-for-service reimbursement models reward volume. For example, physicians are paid per office visit through submission of E&M…

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Will AI Replace CDI Professionals?

In Clinical Documentation Integrity, a primary focus is which technology is the most beneficial – Natural Language Processing (NLP) or a deeper learning Artificial Intelligence (AI). There are different avenues healthcare systems can take when determining how to structure the technology needs for CDI programs. Consider if you want the assistance from information already written…

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Tomato or Tomahto?

language

We have a saying in CDI, “words matter”, and it is absolutely true. Over the years I have learned a valuable lesson – words have different meanings dependent on setting and audience. This may seem intuitive, but I had never thought of it happening within a healthcare setting, where in my mind, we all think…

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Nurse-Led CDI?

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Our CDI model at Norwood is Nurse-Led, Physician-Sensitive, Coding-Supported, and Patient-Centered. I’ve been asked about this a few times – as I believe we are the only program that explicitly states “nurse-led”. Most outpatient CDI programs are physician-led. I completely understand and respect this as healthcare has traditionally been led by physicians. Over the last…

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Grandma’s Apple Pie.

cdi

Who is baking in your CDI kitchen? In the spirit of our theme for CDI week, “CDI Kitchen: Recipes for a Successful Program”, I was thinking about the perfect recipe for a well-functioning CDI program. So many are searching to fine tune the recipe – to get the consistency just right. Unlike a perfectly measured…

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Can CDI Programs Really Make a Difference?

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I have heard it said that the overall goal of Clinical Documentation Integrity (CDI) is to improve documentation for coding and reimbursement. Even though this is in fact a valued outcome of many CDI programs, I argue that it is not the overarching goal of CDI today. With the ensuing complexity of technology, such as…

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Electronic Health Records Creating a ‘New Era’ of Health Care Fraud, Officials Say

“The Justice Department accused eClinicalWorks, an EHR company whose medical software is used by 130,000 providers, of rigging the government’s certification test, claims the company has denied. eCW settled the case for $155 million in 2017.The concern is not just over wasteful spending of tax dollars. EHRs monitor the medicines people take and their vital…

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