Building an Effective HCC CDI Process
Recorded: April 18, 2017
CEU – 1.0 Clinical Data Management
Hierarchical Condition Category coding is the increasing focus of CDI professionals in 2017. Not only can high-quality HCC improve reimbursement and quality scores in the physician practice, the clinical documentation can assist to more accurately assign DRGs in the inpatient setting as well.
Join us for this thought provoking presentation offering new CDI solutions in the physician practice setting for HCC code assignment. Gain an understanding of how to sell and implement a program and how to encourage physician adoption and collaboration.
Learning Objectives: During the session, participants will:
• Learn steps to plan and implement an effective HCC CDI Process
• Understand the challenges related to HCC coding in the physician practice
• Discuss how HCC capture improves clinical documentation throughout the continuum of care
• Learn tips for physician collaboration and adoption for HCC coding
1. Healthcare landscape and need for a change in CDI program design
2. Demands placed on clinical documentation to support risk adjusted payment programs
3. Steps in planning the HCC CDI program
a. HCC audit
b. Return on investment
c. Selling the idea
d. Data requirements
e. Pilot site(s)
f. Work flow
g. Physician collaboration and adoption
4. HCC capture and DRG assignment
5. Next Steps
Co-Presenters: Pamela Hess, Managing Director, CDI at himagine Solutions Inc.
and Terry Buske, Director of Strategic Business Development at himagine Solutions Inc.
Pamela C. Hess is the Managing Director, CDI at himagine Solutions Inc. She is a nationally recognized expert in Health Information Management with extensive healthcare experience in revenue cycle operations, clinical documentation improvement, electronic health record applications, reimbursement, coding, billing, compliance, quality control, and coding training. She is known in the industry as a trusted advisor and subject matter expert, and has authored the original edition of the Hospital Charge Description Master Guide, by OptumCoding, Cardiology Procedural Coding Select, by Decision Health and most recently Clinical Documentation Improvement- Principles and Practice by AHIMA Press. Her experience in the healthcare industry has focused on CDI program implementation at large academic medical centers and medium to small regional facilities. She has extensive experience managing HIM operations as a consultant and as a health system HIM director. Prior to joining himagine, she led the CDI service line for Deloitte & Touche, LLC and Navigant Consulting, Inc. She is currently the President of the Arizona Health Information Management Association.
Terry Buske (Pronounced “Bus-Key”) is the Director of Strategic Business Development at himagine Solutions Inc. He has 25 years’ experience in driving economic improvements in healthcare.
He began his career in billing & insurance resolution. Towards the end of the Clinton administration, he was appointed by the Deputy Director of the Veteran Health Administration to serve on a National Revenue Taskforce; subsequently consulting with Department of Defense Hospitals, DHHS and the Indian Health Services. From there, he progressed to continuous process improvement and helped drive expansion of the 1115 Medicaid Waiver in Texas and California. Prior to joining himagine, Terry was the Sr. Vice President for a private equity group helping incubate healthcare start-ups.
He has been involved with the American College of Healthcare Executives since 2009 and has been mentored by some of the best CEO’s in the Texas Medical Center. As a member of the Healthcare Financial Managers Association and AHIMA; he is passionate about contributing to TxHIMA and supporting regional HIM chapters across Texas.
Access instructions to the recording will be provided within 2 business days following receipt of payment.
- AHIMA Member: $30
- Non-Member: $45
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