PIH Health Successfully Launches CDI Program Through Navigant Engagement

The CDI specialists at PIH Health underwent a seven-week training period

Challenge

A provider’s clinical documentation improvement (CDI) program is vital to its revenue cycle health. A strong CDI program can fix the gaps in cost and quality reporting and — given the amount of change related to electronic health records, ICD-10 and recovery audit contractor audits — there is added impetus for a laser-focused program to target quality documentation and accurate reimbursement. Trained CDI specialists review clinical documents and provide feedback to physicians as part of an ongoing effort to maintain the quality of documentation and provide certainty that the care delivery corresponds to the diagnoses being made.

In 2017, PIH Health partnered with Navigant to launch a new CDI program. The initiative required additional CDI specialists who needed training and support.

Solution

Working with Navigant, the CDI specialists at PIH Health underwent a seven-week training period onsite that included formal classroom education on all Medicare Severity-Diagnosis Related Groups, CDI strategies, and the compliant query process. Additionally, the specialists benefitted from mentoring and one-on-one shadowing — guidance that assisted them in their daily workflow process.

The program’s new workflow design included best practice CDI record review and placement of compliant queries, actions that proved to increase productivity over time. To continue the success and growth of the CDI program, a steering committee was developed that fosters ongoing interaction of the executive team and the CDI specialists. Auditing will be scheduled by the leadership team as part of the oversight function.

Results

Successful Program Launch - Results for PIH Health

PIH CDI - Best Practice - PIH Results

Our CDI program has enabled us to ensure complete and accurate capture of clinical documentation in our patients’ medical records. Navigant was instrumental in helping us to develop our program. We continue to initiate programs that focus on our mission to serve and depend on business partners that assist us in meeting our goals.

Cole Christianson
Vice President, Revenue Cycle
PIH Health

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