Roughly half of a healthcare organization’s revenue stream comes from outpatient care encounters. Clinical documentation improvement is now, more than ever, applicable across the entire care continuum. Outpatient and professional practice care settings involve a variety of complex documentation requirements which, if not managed properly, can translate into revenue cycle pitfalls.
EXTEND’s team of outpatient CDI specialists review, query, and provide recommendations to providers intended to improve documentation completeness, accuracy, and specificity. Enhanced documentation integrity enables both providers and outpatient facilities to demonstrate high-quality care delivery, improve quality scores, and receive accurate reimbursement from payers.
Hierarchical Condition Codes (HCCs) capture: Facilitate proper documentation to support risk adjustment payments related to Medicare Advantage Plans
Merit-based Incentive Payment System (MIPS): Improve capture rate and specificity to support accurate quality scorecards.
Outpatient Quality Reporting Program (OQR): Support quality metrics documentation requirements.
Integrating clinical documentation specialists into outpatient clinical workflows enables practices, clinics, and facilities to successfully monitor of gaps in clinical documentation processes. These specialists work with providers and coding teams to help the provider ensure that the clinical documentation is specific and accurate, using prospective reviews, concurrent and retrospective queries, and provider education.