How CDI Programs Improve Healthcare

CDI (Clinical Documentation Integrity) is quickly becoming one of the most critical factors in cultivating a thriving and productive healthcare practice.

This internal auditing program can help avoid costly coding mistakes, unsupported clinical documentation, and regulatory noncompliance.

Successful CDI programs are the first step in improving processes across your healthcare practice and increasing revenue while protecting providers and patients.

Everything you need to know about CDI programs:

  • What is CDI Program?
  • What does a CDI professional do?
  • What is the difference between Inpatient and Outpatient CDI Programs?
  • How do you implement an outpatient CDI program?

What is CDI Program?

CDI, or Clinical Documentation Integrity, is, in essence, a process in which medical record documentation is reviewed for completeness, compliance, and accuracy. CDI programs are designed to improve workflow and, indirectly, patient care and safety by clarifying documentation, while reducing billing errors and enhancing provider-patient communication.

Unfortunately, many hospitals, clinics, and healthcare practices across the country still need to see the need to implement or support a robust CDI program, at least not in the short term.

Many healthcare providers find that implementing a strong CDI program delivers near-immediate ROI by identifying missed billing opportunities and saving time and money in the long run.

What does a CDI professional do?

In essence, the roles and duties of a Clinical Documentation Integrity professional are straightforward: to ensure complete, accurate, and compliant medical documentation.

Additionally, a CDI professional may assist in acquiring provider documentation within medical records for conditions and treatments to gain a more holistic view of the patient’s medical history, past or current treatment plans, and case complexity.

CDI Professionals should also be education champions, ensuring that your clinical staff members are up to date on documentation guidelines and best practices. Given the increasingly digital nature of the healthcare field, it should be no surprise that a CDI professional should also be adept in using industry-standard medical coding software, including 3M 360, ChartWise, and Nuance, in naming a few.

What is the difference between Inpatient and Outpatient CDI Programs?

Although sharing the common goal of ensuring accurate clinical documentation, there are key differences between inpatient CDI and outpatient CDI. One such example, for instance, is that outpatient practices see a much higher quantity of patients when compared to inpatient admissions on average, meaning that the volume of charts simply does not allow for each to be reviewed. Additionally, the ROI for an outpatient CDI program is not as immediately apparent as with inpatient CDI programs, due to the timing of the healthcare revenue cycle.

In essence, inpatient CDI focuses on accurate diagnostic related group (DRG) assignment for the acute condition, risk of mortality (ROM), and severity of illness (SOI) during a hospital stay. In contrast, outpatient CDI focuses on hierarchical condition categories (HCC) and risk adjustment factors (RAF) capture of chronic disease.

How do you implement a CDI program?

CDI is essential for a thriving healthcare business, clinic, facility, or hospital. With knowledgeable professionals, implementing such a program is easy. Harmony Healthcare, one of the nation’s leading healthcare consulting companies, can deliver a true turnkey CDI solution in both inpatient and outpatient populations, from beginning to end.

Get in touch with Harmony Healthcare today to learn more about how they can take your healthcare business to the next level.

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