Challenge: 

A large multi-state IDN was focused  on maintaining financial accuracy and sustainable revenue through a proactive approach ensuring physician documentation supports coding compliance, MS-DRG accuracy, and quality performance data.  Additionally, knowledge transfer was a critical component to strengthen its CDI program across the enterprise. 

 

Solution: 

Implementation of Enjoin’s Pre-Bill Program with high value high impact chart reviews focused on provider documentation, coding and query opportunities, and overall coding compliance/accuracy.

Additional goals were to increase physician engagement, optimize revenue lift and leverage knowledge transfer to CDI and Coding with advanced clinical acumen.

 

Outcomes: 

While revenue optimization is important, just as critical is the opportunity for knowledge transfer. Within two years of Enjoin’s Pre-Bill Chart Review Program, this Client experienced a gain of $5.9M representative of both cost savings and estimated revenue recovery with knowledge transfer through monitored performance and actionable insights.

There Is A Difference

  • Focus list management for high value high impact
  • Advanced clinical acumen and clinical coding expertise accuracy to drive revenue integrity and mitigate financial risk
  • Educational resources to support knowledge transfer and CDI program advancement
  • Increased engagement of the CDI Team (Coders, CDS, Physicians)