What is Remote CDI?

Physician CDI Specialists review your facility medical records and focus on three objectives

Clinical Validation

– Identification of Clinical Indicators for diagnoses and procedures to
justify Medical Necessity and Code Linkage

Coding Audit

– Clinical review to support assignment of ICD-10-CM/PCS and CPT-4 codes

CDI Quality and Accuracy

– Application of Best CDI practices

cdiWorks services includes client support with:

• Clinical validation
• Query generation
• Internal audits of records
• Clinical review of denial cases and submission of appeal letters

Value Proposition

• Increased SOI/ROM scores in IR-DRG payment system
• Increased SOI/ROM capture rate for APR-DRG payment system
• Increased MCC/CC capture rate for MS-DRG payment system
• Proper assignment of Principal Diagnosis Codes
  (APR-DRG, MS-DRG and IR-DRG payment systems)
• Case Mix Index (CMI) Improvement
• Length of Stay (LOS) Decrease

VALUE:

Value: 

• Clinical and Coding Review of Each Record
• By ONLY Experienced, US Practicing Physicians
• Physicians with CDI and Coding Credentials
• Physicians with Knowledge of CDI and ICD-10-CM/PCS and CPT-4 Coding Guidelines

Value:

• Focus on Physician review of live records with query generation and clinical review of denial cases
• Commitment to deliver Physician CDI input for each record within 12 to 36 hours
• Scalable, 20 – 300 records per week
• No overhead for your organization
• Minimum cost-per-record review

Value:

• On average, Physician CDI service has achieved Return on Investment (ROI) of 380% to 460% (3.78 to 4.62) on volume
• Focus on generating additional revenue with clinically robust DRGs and high quality documentation

Value Examples:

Tracheostomy Case Study/NY City Hospital

One Missed (queried by cdiWorks) Word = $99k in Additional Revenue

• Patient with sepsis and acute respiratory failure requires mechanical ventilation on admission. An emergent bedside procedure is performed for airway access. Patient expires after 3 days.
• CDI Team generates query to clarify the type of emergent bedside procedure performed. Physician responds to query and makes Addendum in Bedside Procedure Note: “Tracheostomy was performed”.

DRGs, Relative Weight and Reimbursement

• MS-DRG 871, Relative Weight 1.8564, Reimbursement $21,055
• MS-DRG 004 (with Tracheostomy), Relative Weight 11.4192, Reimbursement $119,953

Positive CDI Impact (additional Revenue): $ 98,898