Essential Leadership and Management Skills in CDI
Course Modules
1. Introduction to CDI
We recognize that often individuals are assigned the responsibility of management of a CDI department or CDI staff without pre-existing knowledge of the role and responsibilities. This course begins with a discussion about the role and the regulatory guidance that directs CDI practice.
2. IPPS & MS-DRGS
Keeping with the same tenet as module 1, we discuss the Inpatient Prospective Payment System and the CDI function related to code assignment and MS-DRG grouping. This module offers a surface dive into CDI function and how it impacts the inpatient population.
3. Introduction to Outpatient CDI
We discuss the evolution of CDI into the outpatient setting. We review CDI efforts related to emergency department, observation and primary care/clinic reviews reviews. The discussion continues speaking to the various missions related to outpatient CDI to include: denials prevention, risk adjustment, charge capture and quality.
4. Other Payer Systems
The discussion of healthcare reimbursement is continued touching on a number of methodologies within both the inpatient and outpatient settings to include bundled payments, accountable care organizations, risk adjustment, provider billing etc.
5. Health Care Data & Public Reporting
The impact of CDI function upon quality reporting is well established within the industry. We discuss a number of the CMS quality monitors and CDI function related to the reporting of this data and organizational reimbursement.
6. CDI Practice: Record Review & Query
This module reviews the basics of CDI function to include record review and query compliance.
7. Revenue Cycle Audit Activities
Understanding compliance is a core competency for CDI function. This module speaks to the number of efforts in place to monitor compliance to include RAC, OIG, and PEPPER data.
8. CDI Metrics
A manager must monitor and communicate staff function and effectiveness. We discuss a number of standard metrics used to measure departmental function and benchmarking.
9. Managing Your CDI Staff
Managing a staff can be a challenge. This module offers direction related to functions of managing a staff and CDI program to include screening applicants, interview, hire and training. The discussion includes considerations related to remote CDI function and competency assessment.
10. Directing Your CDI Department
Differing from management is the responsibilities of directing a department. This module offers guidance related to departmental mission, reporting structure, staffing models, written policies, job roles etc.
11. CDI Expansion: Managing Change
The impact of CDI is growing, managers must thoughtfully engage in this process to plan change and grow your department and mission.
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For more detailed information about our Boot Camps, contact us at 615-724-7200 or email PD-IS@SimplifyCompliance.com.
Essential Leadership and Management Skills in CDI
Course Locations & Dates
Below is the current course schedule for upcoming classes of this CDI Boot Camp. We update this schedule on a regular basis.
Registrations are processed in the order received. Class size is limited, and classes often sell out. We recommend against making travel arrangements until after we have confirmed your course registration.
To register for a class, click the "Register" button. If you would like to register multiple attendees, fill in the "Additional Attendees" box.
For larger groups, contact Customer Service at (800) 650-6787 to inquire about group rates.
Locations marked as "Tentative" are subject to change.
To view our cancellation policy, click here.
September 2023
|
Hyatt Place Atlanta/Buckhead
|
Essential Leadership and Management Skills in CDI
Course Outline/Agenda
Day 1 (8:00 a.m. — 5:00 p.m. to include lunch break, 30 minute, and 4 10‐15 minute breaks)*
Introduction to CDI
Impact of Documentation
Roles- CDI & Coding Professionals
UHDDS Definitions/Reportable Diagnoses
ICD-10 CM/PCS
The Official Guidelines for Coding & Reporting
IPPS & MS-DRGS
IPPS Reimbursement Methodology
CDI Process & IPPS
Introduction to Outpatient CDI
ED setting
Observation patients
Primary Care/Clinic Settings
Other Payer Systems
APR DRGs
Bundled Payment
Per Diem Rates
Risk Adjustment
Medicaid
Commercial Insurance
OPPS (APCs, Evaluation & Management)
*The timing may change as the course is presented to allow for discussion.
Day 2 (8:00 a.m. — 5:00 p.m. to include lunch break, 30 minute, and 4 10‐15 minute breaks)*
Health Care Data & Public Reporting
Public Reported Data
Adverse/Never Events
CMS Quality Measures
Hospital Readmission Reduction Program
Hospital Acquired Condition Reduction Program
Hospital Value Based Purchasing
Patient Safety Indicators
MACRA
CDI Practice- Record Review & Query
The CDI Process of Record Review
Inpatient Setting
Outpatient Setting
Compliant Query Practice
Revenue Cycle Audit Activities
Comprehensive Error Rate Testing
Recovery Auditors
Program Safeguard Contractors
Office of the Inspector General
Medicare Administrative Contractors
Quality Integrity Organizations
Supplemental Medical Review Contractor
Risk Adjustment Audit Validation
Commercial Audits
PEPPER Data
CDI Metrics
Key Metrics Used in CDI
Using Metrics to evaluate:
CDI Productivity
Provider Engagement
Educational Needs
Staff Performance
* The timing may change as the course is presented to allow for discussion.
Day 3 (8:00 a.m. — 4:00 p.m. to include lunch break, 30 minute, and 4 10‐15 minute breaks)*
Managing Your CDI Staff
Traits/credentials of a successful CDI
CDI Job Descriptions
Interview/Hire/Train
Preceptors & Mentors
Evaluating Staff Performance
Career ladders
Competency Assessment
Remote CDI
Directing Your CDI Department
Key Department Policies
Query
Escalation
Reconciliation
Internal Audit
Staffing
Remote Employment
Dress Code
Specific CDI Job Roles
Physician Advisor
CDI Educator
CDI Auditor
CDI Analyst
CDI Denial Management
Committees & Groups
Provider Engagement
Multi Campus Management
Vendor Contracting
CDI Expansion- Managing Change
Potential areas of expansion
Managing the process of expansion
* The timing may change as the course is presented to allow for discussion.
Essential Leadership and Management Skills in CDI
Learning Objectives
-
Explain how organizations are reimbursed under the IPPS
- Understand the significance of the MS-DRG reimbursement methodology and discuss its associated key elements like Present on Admission (POA) and Hospital Acquired Conditions (HACs)
- Compare and contrast the IPPS and OPPS
- Discuss OPPS topics such as APCs, provider E&M, HCCs
- Discuss payment methodologies such as bundled payments, ACOs, risk adjustment, per diem rates, Medicaid and private insurances
- Discuss the use and impact of publicly reported healthcare data
- Discuss CMS quality reporting and potential for CDI impact
- HRRP
- HVBP
- PSI
- HACRP
- MACRA/MIPS
- Describe the traditional role of the Clinical Documentation Specialist (CDS)
- Define the role of a “query” in CDI/coding
- Identify and discuss the resources available to guide when and how to query based on professional industry standards
- Recognize the importance of creating policies to define the query process and discuss the basic elements that should be addressed in the policy
- Describe the function and focus of the following audit initiatives
- Comprehensive Error Rate Testing
- Recovery Auditors
- Program Safeguard Contractors and Zone Program Integrity Contractor
- Office of Inspector General
- Medicare Administrative Contractor
- Quality Integrity Organization
- Supplemental Medical Review Contractor
- Commercial Audit
- Risk Adjustment Data Validation
- Discuss the skill set & personality traits of a desirable CDI specialists
- Identify items to be included within a CDIS Job description
- Discuss the planning and implementation of an interview
- Identify steps needed to develop a thorough & complete training plan
- Apply the concept of career ladders to CDIS
- Identify methods of competency assessment/employee performance assessment
- Discuss the pros & cons related to remote CDI practice
- Identify policy considerations related to the management of remote staff
- Identify key departmental policies related to CDI
- Discuss Specific job roles related to CDI & their responsibilities
- Discuss CDI reporting structures & communications within an organization
- Discuss opportunities and methods related to provider engagement
- Identify considerations applied to managing across several facilities
- Discuss the many possible foci of a CDI Program
- State the importance of a clear, defined departmental mission
- Demonstrate how to use a mission statement to evaluate needs related to growth and expansion of the CDI department
- Discuss how to communicate your concerns related to expansion of your present responsibilities
Essential Leadership and Management Skills in CDI
Continuing Education
ACDIS
This program has been approved for 21.5 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification and CCDS-O (outpatient) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).
AAPC
This program has prior approval of the AAPC for 21.5 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the AAPC of the program, content or the program sponsor.
AHIMA
This program has been approved for continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting of Approved CEUs from AHIMA does not constitute endorsement of the program content or its program provider.
Essential Leadership and Management Skills in CDI
COVID
Simplify Compliance and HCPro place the highest priority on the safety of our guests. In preparation for attendance at our events, we want to share the following measures to promote health and well-being:
- Per current CDC guidelines, if the county where our event is located is deemed to be within the high level of COVID-19, it will be recommended that all attendees, regardless of vaccination status, wear masks when indoors except while actively eating or drinking.
- Food service will follow the safety guidelines implemented by the hotel.
To view all the safety measures that a specific hotel has implemented, please see the information listed on their website.
Simplify Compliance and HCPro will continue to monitor the COVID-19 environment and the recommended guidelines and will communicate adjustments to the onsite policies and procedures as necessary.