Description: As a cornerstone of revenue cycle management, documentation impacts clinical care, risk management, reimbursement, and quality metrics. But silos within the process lead to claims being submitted with incomplete or inaccurate information. The result is an aging AR ledger, rising denials, and a backlog of DNFC/DNFB cases. This not only impacts reimbursement, but also disrupts the patient’s care journey. Leading health systems take a holistic approach to documentation, addressing outstanding gaps from multiple angles, encompassing both early efforts are coding and CDI in the revenue cycle and downstream DRG validation. 

By building a continuous improvement cycle that informs and educates across coding, CDI, and DRG validation efforts, revenue cycle leaders can proactively leverage data to drive better documentation and increase coding efficiency.

Learning Objectives:

In this session attendees will learn:

• Continuous improvement strategies to improve coding accuracy and relieve staffing challenges
• Unforseen pitfalls across CDI, coding, and DRG validation, and which KPIs to monitor to identify issues before they arise
• How to take a quality-first approach to drive documentation excellence

Webinar Date: This was presented as part of the OHIMA 2024 Annual Meeting & Trade Show - March 18, 2024.
Duration: 1 hour

Speaker:  Sandra Routhier (Sandy), RHIA, CCS, CDIP, is an HIM, Coding, and CDI professional with more than 35 years of experience with a strong emphasis on inpatient coding and reimbursement, medical record documentation requirements, HIM operations, electronic records, regulatory and accreditation requirements. Sandy worked in acute care hospitals for the first 25 years of her career in a variety of roles including inpatient coding and CDI specialist, HIM director, revenue cycle director and information systems director. Sandy is the Senior Vice President of DRG Validation (DRGV) Auditing Services at cloudmed. DRGV provides a unique full-coverage software and auditing solution to assure the accuracy of coding and documentation on inpatient cases. Sandy plays a key role in the development and maintenance of the rules engine and auditing process for DRGV.

Speaker: Nichole Baca, BS, BSN, RN, CCDS, has a Bachelor of Science in cellular and molecular biology from the University of Washington and a Bachelor of Science in nursing from the University of New Mexico. She spent 7 years working in MICUs, CVICUs and SICUs, before finding her passion in the little-known realm of clinical documentation improvement (as it was known then). When ICD-10 implementation began, she was asked to become her hospital’s ICD-10 physician educator, presenting ICD-10 documentation education to the service lines throughout her organization. She then moved into a leadership role, as a senior manager. In this new role, she partnered with coding leadership to develop a CDI/Coding education for new provider orientation, which she presented quarterly to all newly hired providers within her organization. She was also selected as a panelist on creating a hybrid remote CDI program for the ACDIS 2019 conference and authored an article on technology use in remote CDI that was published in the March/April 2019 ACDIS Journal. She has since joined R1RCM as Senior Director of Clinical Documentation Integrity, where she gets to travel the country, doing what she enjoys the most, educating CDI staff, leaders and providers on the importance of documentation and nuances of coding guidelines.

Click here to register for this webinar!

Cost: $25 Members / $35 Non-Members
1 AHIMA CEU*
Domain: Revenue Cycle Management

*AHIMA CEUs are also accepted by the AAPC! Check eligibility on the AAPC website.