Conference Update: Speaker Q&A

To help you get revved up and rearing to go this year, we’re previewing a handful of speakers throughout the coming weeks to give you a feel for the sessions. This week, we spoke with Adelaide M. La Rosa, RN, BSN, CCDS, who, along with J. Peter Savini, BA, MHA will present “Revenue Cycle: Overview and Its Relationship to CDI.”

Q: Why is it important to understand the revenue cycle’s relationship with CDI?

A: As CDI specialists, our job is to make sure that whatever has been provided as care is accurately documented so it can appropriately translate to codes. When we put coding out there, we are determining the payment the hospital is entitled to and the DRG it is going to get. If we as CDI specialists are helping present the true overview of treatment and are capturing information, getting physicians engaged, and making sure there is complete coding, the end result will be long-term financial stability. Hospitals know expected revenues and plan budgets ad goals for what they need to do, and these budgets impact case mix and the patient population. It is important for CDI to understand that their day-to-day functions are part of what is driving the revenue cycle.

Q: How is your topic important for everyone in the CDI role, regardless of professional background?

A: There is a financial and clinical balance that must be taking place every day, and CDI needs to know what that means. They need to be aware of cash billed versus cash received and ask what patients we should be looking at to see additional opportunities. CDI specialists cannot just see themselves as simply getting diagnoses, CCs, and MCCs. They can play a significant role in finding a population of patients for review opportunities.

Q: As an RN, how does your perspective differ from other professionals performing the CDI role?

A: Having been on the floor as a nurse, I have communication skills to query physicians and the clinical background to understand what is going on. That clinical knowledge is very important. However, those without clinical experience, like coders, aren’t unfit for the job—but it does help expand how you would further review a chart.

Q: How did you become interested in CDI?

A: I did bedside nursing and floor nursing, and was always very driven about understanding when DRGs were coming into play and what that was all about. I was fascinated by the reimbursement aspect, too, and wanted to take my clinical knowledge and apply it to a different role. I may not be directly touching the patients with CDI, but there is an indirect impact, making sure the communication of care is clearly documented in the chart, so anyone picking up the chart can understand what’s going on.

Q: What are you most looking forward to at the ACDIS conference?

A: Meeting other professionals and networking. I’ve been doing this a long time, and am always interested in what else I can learn to grow as a leader, further enhance my clinical knowledge, and further understand the world. ACDIS does a great job of bringing a team of professionals together and offering them different breakouts that are great for new or experienced CDI professionals.