Conference conversations: Denials data and how to use it for outpatient endeavors
see all the posters and descriptions of their
contents under the "Conference Materials" section
of the "Resource Library."
Editor’s note: Vinita Magoon, DO, JD, MBA, MPH, CMQ, is a clinical documentation and quality improvement physician at Baylor Scott & White Health in the greater Austin, Texas, area. Dr. Magoon presented a poster at the 2018 ACDIS Conference entitled “Using denial data to improve outpatient clinical documentation.” Though the conference has ended, visit the ACDIS website in the following weeks to see all the posters and descriptions of their contents under the "Conference Materials" section of the "Resource Library."
Q: What made you want to submit a poster this year?
A: The conference agenda includes an outpatient track and I wanted to contribute to the growing field of outpatient CDI.
Q: How did you decide on a topic?
A: I have found denial data to be a useful source of information on how providers can improve documentation/coding. It’s also useful in identifying missed documentation opportunities. Using denial data to create education is impactful in improving claims accuracy, reducing denials, and increasing revenue and I want to share this approach with other organizations.
Q: How have the outpatient physicians responded to the denials data you've presented?
A: Since our denial data can be analyzed based on specialty, we can create education that is specialty—and clinic-focused. Using specific, relevant examples is a good way to engage providers in improving their documentation and subsequently, they have taken an active role in CDI.
Q: Did you work with any other departments during the process? If so, which ones and why?
A: I work closely with our compliance, HIM/coding, and revenue cycle departments to make sure our messaging is aligned. I also work with our clinic leaders and providers to make sure the education is useful and relevant.
Q: What would you recommend to someone looking into their outpatient denials data for the first time?
A: It would be beneficial to sit down with someone who is familiar with claims processing so that the reviewer can understand the source of the data. Denial data for an entire healthcare system can seem overwhelming, so learning how to prioritize the information and address high impact areas first is the best approach.
Q: What's one thing you're excited for at the ACDIS 2018 conference?
A: I’m excited to learn how other organizations are approaching outpatient CDI since it’s such a new area.