JThomas_Clinical Documentation Worksheet_112623

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Rasmussen College, Florida *

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M208/HIM20

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Dec 6, 2023

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HIM2000 Module 03 Assignment Clinical Documentation Instructions: Thoroughly complete and submit this worksheet. 1. Explain the purpose of CDI. To initiate concurrent, as needed retrospective reviews of health records for conflicting, or nonspecific documentation 2. List key CDI stakeholders and explain why they are important to the process. Executive leadership: To help assist those within the care of patients and direct staff as needed and help guide staff. HIM & Coding departments: To obtain medical records and process them appropriately and accordingly. Compliance and Ethics: To ensure all documentation, guidelines and policies are being followed. Finance and revenue cycle: Helps with the processing of medical bills to insurance companies and other revenue outlets. 3. Why are clear cut goals critical for a successful CDI program? Give a couple of examples of meeting goals. Clear cut goals are critical for a successful CDI program because of the need for accuracy in documentation for many purposes, such as billing. Meeting a goal could be providing awareness and education to providers whom do the documentation. That can also help to promote health record completion which promotes patient safety. 4. What is the role of queries in the CDI process? The roles of queries are to initiate and instill thorough documentation. 5. What is query management? Evaluation of the quality of healthcare services and delivery using standards and guidelines developed by various entities, including the government and independent accreditation organizations 6. What are the CDI tools and how are they used? CDI QA. Helps monitor the work of a CDI professional. Computer assisted coding and the EHR: Can be used to help improve documentation, coding, data extraction etc. 7. What are CDI metrics? What is the value of metrics to the CDI process? List 2 or 3 metrics that you feel would be of most value in a CDI program for coders. Measures to evaluate CDI programs, the organization, and employees. Review rate, query rate, response time, quality/revenue impact. 8. Explain the role of physicians in CDI? They are a liaison between the CDI staff, hospital coders, CDS and the facility medical staff. Their role is reviewing charts to identify areas for improvement in
HIM2000 Module 03 Assignment documentation. 9. Every CDI program startup face challenges. List the six (6) challenges addressed in the toolkit. Administrative support Physician buy-in and engagement Training and education Hiring right people in CDI positions Budget Staffing 10.Which challenge do you think is the most significant? Explain why. I think they all are significant, if you are missing one or two of the 6, that could be enough to put a stop to the program. 11.Every start-up program requires data to make decisions about what the program needs to address. Some examples could include at least 12 months of DRG data, coding issues, denial causes and other case mix data. What other decisions have to be considered and made before implementing a CDI program? Budget, Training needs, who will train, Location of training, Scope of practice, Alignment of the CDI program, number and frequency of chart reviews, who will comprise the CDI staff 12.Maintaining a successful CDI program takes more than just reviewing patient charts to validate DRG assignment and working with physicians. What does a successful CDI program require? Effective plans are built on a foundation of purpose, vision, mission, and short- and long-term goals. For a successful CDI program to be maintained, a plan should be in place to address the need for ongoing and/or updating education of CDI professionals on ever-changing codes, rules, regulations, and guidelines. 13.CDI programs require skilled personnel. What are the skills or core competencies needed for a CDI Specialist? Knowledge of medical record keeping. Medical terminology, coding and procedures. Ability to communicate effectively. 14.There are a number of techniques CDI professionals can use to reduce denials. List four Revenue cycle outsourcing, Varying payer guidelines, Coding changes, Medical Necessity, modifiers
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