Our Ask The Experts series provides helpful and informative answers to questions that are submitted directly from you, who work in the hospital space daily, from our highly skilled team of Health Information Management (HIM) Experts at Peak Health Solutions.
Do you often wonder how you can continue to improve your Mid-Revenue Cycle through Medical Coding, CDI, Compliance and Revenue Integrity, Auditing, Denials Management and HIM optimization? If so, please submit your question through Ask the Experts today and see your question covered in an upcoming issue.
We implemented our CDI program three years ago, but we haven’t seen the type of additional revenue capture from our investment as the Leading Hospital System did in your CDI Case Study. It appears you built their system from the ground up, but ours is already in place. Does your program offer optimization opportunities for existing programs?
Justin Schmidt, Senior Vice President & Founder:
Great question. We’re glad you found our CDI Case Study informative. The short answer to your question is yes. The Peak CDI team is adept at evaluating existing CDI programs within organizations of all sizes. We can identify key opportunities for improvement and help you put those changes into practice to maximize revenue capture.
Before any CDI program can run, it has to walk. With that in mind, we've created a set of fundamental processes we follow. These steps help ensure any CDI program, large or small, gets the best possible return on investment.
The first and most critical step is a detailed assessment of your existing CDI program. With the assessment, we establish a baseline and build an understanding of what is working and what isn't. We gather necessary information on the collaboration between Physicians, CDI Specialists and Coders working in tandem and analyze the results.
A few of the factors we may assess includes:
- Evaluation of current process to establish baseline information
- Provider documentation
- Evaluation of any facility standards or protocols for assignment of diagnosis (e.g.: Facility criteria for acute renal failure, respiratory failure, thrombocytopenia, post-op complications, etc.)
- Physician engagement in the query process
- Coder evaluation and education
- Evaluation of CMI to identify targets for revenue increase
Next, our team of CDI experts goes to work. We identify places we can help you improve and establish ongoing procedures that ensure success. Our team can fill in knowledge gaps, educate coders and physicians on best practices and help you create an environment where the benefits of CDI are clear to everyone.
In our experience, we've found that the most successful CDI programs are ones that employ fluid processes that adapt to the nuances and changes of the industry. There is no "one size fits all" CDI solution, but rather a key set of principles, skills and ongoing procedures we help you put in place to ensure success.
You've made the commitment to put a CDI program in place for a reason. Large or small, any healthcare organization can benefit from an effective CDI program that helps capture more revenue. If that's not happening, Peak can help. Our goal simple. We want your CDI program to capture more revenue and for you to be a success.
Do you have questions about how you improve your Mid-Revenue Cycle you'd like answered by the experts at Peak Health Solutions?
Profile of our Expert
Justin Schmidt, Senior Vice President & Founder
Justin Schmidt is a co-founder and President of Peak Health Solutions. Justin has over 15 years of experience in healthcare management and has played a vital role in managing and building the Provider Business Unit for Peak Health Solutions. He is the key leader around the strategic planning for Peak both domestically and internationally which include operations, financial management and sales/marketing. In addition, he is responsible for the growth and management within the Government business unit for Peak Health Solutions. Justin has a degree in Business Administration from Boston University.