Retrospective Reviews: The last line of defense?
Each stage of the CDI documentation integrity process represents an opportunity for additional leakage of accurate and appropriate documentation, resulting in inaccurate coding of conditions being monitored and treated during the patient's encounter. This results in inappropriate reimbursement for care provided as well as potentially imperfect quality reporting. And despite massive investments in documentation and coding solutions, earned revenue loss continues to persist -- Medicare and Medicaid underpayments reached $75.8 billion in 2019*.
Retrospective reviews are the last opportunity to resolve documentation and coding issues for billing and quality reporting purposes. Traditional reconciliation is inefficient and often ineffective for a number of reasons, including: inefficient process, understaffed CDI teams and lack of technology that supports accurate identification of opportunity.
During this webinar, we’ll discuss strategies for implementing a more robust retrospective review process, including:
- Why current approaches for retrospective reviews aren’t working
- Strategies for prioritizing what to review
- Solutions for automating the Retrospective review process
*AHA Fact Sheet: Underpayment by Medicare and Medicaid January 2021