Scenario

The past six months, Regency Health Center has seen an increase in the number of inpatients discharged. Regency Health Center has averaged around 1500 discharges per month in the past two quarters. However, the health center also noticed a decrease in inpatient reimbursement. Jane Morris, the Chief Financial Offer (CFO), called a meeting with the HIM Director, Jeff Dunbar, the Chief Medical Officer (CMO), Dr. Steve Stroud, and you, the Quality Improvement Manager. From the meeting, it was discovered that coding productivity decreased when the facility's 15 inpatient coders were allowed to work remotely due to the implementation of the new EHR system. It was also noted that coders are now querying the physicians more than usual due to unclear or incomplete documentation in the EHR.

You have a Registered Health Information Administrator (RHIA) certification and understand the impact of coding productivity and physician documentation on the revenue cycle. You will work with the HIM Director, CMO, and CFO to determine a plan of action to get the coders back on track and increase the quality of physician documentation.

To begin the plan of action, you have decided it will be best to start with some ideas that you have for the coders and healthcare providers. Those ideas include setting performance goals for the coders and hiring a Clinical Documentation Improvement (CDI) Specialist to work with the providers on their documentation practices. You decide to send a proposal to the CFO, CMO, and HIM Director with your suggestions.

Instructions

Prepare a proposal to send to the CFO, CMO, and HIM Director that:

• Recommends performance improvement goals for the remote inpatient coding staff based on your research and benchmarking of coding productivity.
• Assesses the importance of quality healthcare documentation to assure compliance with organizational and reimbursement guidelines.
• Appraises the impact of clinical documentation integrity processes as a component of the revenue cycle.
• Recommends hiring a CDI Specialist to work with the physicians.
• Defends your recommendation by aligning it with your assessment of quality healthcare documentation and clinical documentation integrity processes.