The Impact of CDI in Capturing Earned Hospital Revenue

Clarion Hospital – Clarion, PA

Clarion Hospital, a 77-bed osteopathic teaching hospital in the Northeast, faced challenges similar to those of many other hospitals across the nation. As a teaching hospital, a variety of interns and residents rotated through the hospital, providing care. This constant movement often led to physicians, coders and nurses who did not “speak the same language,” and as a result, the coded data did not always accurately refl ect the acuity of the hospital’s patients. Clarion coders were coding non-specifi c documentation and, as a result, not accurately supporting patient severity of illness and risk of mortality statistics. This nonspecific documentation impacted the Case Mix Index (CMI), causing a downward spiral for the hospital. Clarion Hospital engaged Quorum Health Resources’ Clinical Documentation Improvement (CDI) consultants to help identify opportunities to improve training and communications between the physicians and coders, and to help the hospital be certain that its documentation accurately reflected the high quality of care provided by the hospital.
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