Vee Healthtek was approached by one of the largest hospitals in the Midwest, which was experiencing major revenue loss caused by improper clinical documentation. Due to documentation discrepancies involving high-impact diagnosis related groups (DRGs), the hospital had multi-million-dollar leakage. The physicians were not properly trained on the importance of accurate documentation on revenue, which led to inconsistent physician notes and missed diagnoses.
Vee Healthtek’s clinical documentation improvement (CDI) team stepped in to help the hospital transform its documentation process. Having corrected similar issues at health systems across the country, we were able to solve the problem quickly and efficiently. Leveraging our customizable provider education program, our experts worked with physicians to review best practices and strategies for clinical documentation.
Our tailored CDI solution met the client’s requirements and industry standards for compliance. We started by performing a comprehensive analysis of the hospital’s documentation process to identify areas for improvement. By assessing the number of CDI physician queries, tracking productivity rates, and evaluating the consistency of the documentation, we determined the subjects that would be the focus of our CDI training.
Our certified MDs reinforced that proper documentation helps ensure accurate medical coding and claims while also improving the quality of patient care. We emphasized that incomplete documentation leads to medical coders missing crucial information required for claims, leading to reduced reimbursement rates for the hospital. Moreover, this incorrect documentation exposes hospitals to compliance risks that could have significant legal consequences. Our MDs also provided valuable information on coordinating with other care providers, such as RNs or specialists, and prioritizing compliance.
Finally, we implemented bi-weekly reports for each physician to track how many queries were being generated by medical coders. The fewer queries received, the better the physician was at providing complete and compliant documentation.
Vee Healthtek’s CDI program went above and beyond to address the hospital’s revenue loss due to documentation discrepancies. By analyzing the client’s documentation and implementing CDI training, we achieved 100% physician compliance in less than one quarter. Our client saw decreased queries as a result of proper documentation practices, which led to a 35% increase in cash flow. With our CDI processes, we ensured that no high-impact DRGs, SOIs, or ROMs were recorded incorrectly.
To track the KPIs of our CDI program, we provided bi-weekly reports to the hospital executives to showcase the improved productivity, increased reimbursement, and reduced revenue leakage we have provided. Our client found that our solution created an impact Beyond Expectations and decided to replace both its RCM and HIM providers with Vee Healthtek.
