Most clinical documentation improvement (CDI) programs have been developed inside hospitals with an inpatient focus. Now is the time to focus on your Outpatient programs. Bill Dunbar and Associates (BDA) defines outpatient CDI as reviewing documentation in the outpatient setting and/or the emergency department (ED) to ensure medical necessity and documentation appropriateness to support the codes billed. For those with Medicare Advantage (MA) contracts, a BDA CDI specialist can target diagnoses impacting Hierarchical Condition Categories, or HCCs, a payment methodology associated with patients seen in the physician practice setting.
Outpatient CDI is still being defined, and a variety of opportunities exist regarding the review of provider documentation entered during an outpatient or provider encounter. Outpatient CDI expansion is clearly a necessity.
Many organizations do not have the staffing and/or expertise to implement a CDI program. Many benefits why BDA can partner with your organization: