As focus shifts to outpatient care and quality measurements, hospitals must ensure accurate documentation across all settings to secure appropriate payment for services, avoid penalties and drive continued payment and incentives. Using ProHealth Care, Inc. as a case study, presenters will discuss strategies to build and sustain a high-performing outpatient CDI program in the emergency department and physician practices and clinics. Improved documentation in ProHealth’s ED generated an additional $3.1 million in annualized revenue. In the physician clinics, increased capture of hierarchical condition categories and appropriate risk-adjustment factor scores are anticipated to deliver $1 million in additional revenue.
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