The Physician Advisor's Role in CDI

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The Physician Advisor's Role in CDI

Product Code: CDI05012022A

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ACDIS Conference!

The Physician Advisor's Role in CDI

Sunday, May 1, 2022 — Monday, May 2, 2022 | Orlando, FL

Join us for The Physician Advisor’s Role in CDI, the nation’s only event dedicated to the CDI physician advisor. Our most popular pre-conference event returns for its 11th straight year with new content delivered by some of the best physician advisors and educators in the country.

On Day 1 attendees have their choice to attend one of two tracks. Track 1 is our popular Physician Advisor 101: Core Skills and Responsibilities with Trey LaCharité, which teaches the nuts and bolts of the physician advisor role and is best for those new to the role. Track 2, Expanding and Innovating the Role of the Physician Advisor, features presentations by physician advisors from some of the nations’ leading organizations including Mayo Clinic, Roper St. Francis Healthcare, and Vidant Health.

You’ll be exposed to a wide range of topics including implementing an outpatient CDI program, leveraging your EHR to optimize documentation workflow efficiencies, achieving buy-in with your C-suite with metrics and outcomes, strengthening mortality reviews, PSI review strategies involving complex clinical scenarios, and much more.

If you are new to the role or back to learn something new, we’ve got you covered!

The Physician Advisor's Role in CDI

Learning Objectives

At the conclusion of this program, participants will be able to:

  • Explain the optimal role of the physician advisor in a CDI department
  • Identify optimal metrics to drive provider engagement, systemwide improvement, and CDI department growth
  • Discover diagnosis clarification opportunities to improve value-based purchasing metrics and risk-adjusted outcomes
  • Describe best practices for starting and growing an outpatient CDI program with technology and physician support
  • Discuss techniques for engaging the C-suite in CDI initiatives

The Physician Advisor's Role in CDI

Agenda

Day 1—Sunday, May 1, 2022

Track 1: Physician Advisor 101: Core Skills and Responsibilities

Trey LaCharité, University of Tennessee Medical Center

7:00 a.m. – 8:00 a.m.
Breakfast

8:00 a.m. – 9:00 a.m.
Achieving Medical Staff Buy-in

  • How to explain the goals of your CDI program
  • What your providers don’t know about their documentation and their publicly reported performance data
  • What your providers don’t know about your facility
  • How to explain why CDI is crucial for your providers’ future and their facility

9:00 a.m. – 10:00 a.m.
Ready, Set, Intervene! Managing Problems, Pitfalls, and Personality Disorders

  • Understanding the obstacles you and your program will face
  • 10 rules for ensuring CDI program success
  • Strategies to improve medical staff compliance
  • Practical suggestions for that difficult provider conversation

10:00 a.m. – 10:15 a.m.
Break
 

10:15 a.m. –11:00 a.m.
Well … What Should I be Putting in the Chart?

  • Review the basic documentation practices every provider should routinely employ
  • Review best practices for operative note construction
  • Helpful documentation practices to ensure medical necessity and correct hospital status determinations
  • Learn strategies to encourage provider adoption of new documentation habits

11:00 a.m. – 12:00 p.m.
Stay within the Lines! How to Conduct a Compliant CDI Program

  • Understand CMS’ “Double Jeopardy” for hospitals
  • 10 rules to stay on the straight and narrow
  • Review acceptable CDI query construction practices
  • Review when provider queries are needed

12:00 p.m. – 1:30 p.m.
Lunch (provided)

1:30 p.m. – 3:00 p.m.
Stop, Drop, and Roll! Managing the Unexpected Fires

  • The impact of your CDI program on other hospital departments and how to manage those issues
  • Review EMR-specific risks for your CDI program
  • Understand why your facility is a recovery auditor target
  • Learn specific recovery auditor tactics employed to issue denials to your facility
  • Handling other unanticipated problems in CDI

3:00 p.m. – 3:15 p.m.
Break

3:15 p.m. – 4:30 p.m.
Practical Considerations: CDI Team Structure and PA Position Development

  • Suggestions for CDI team composition, organization, and how to get them up to speed
  • Review successful CDI physician advisor characteristics
  • Who should be your CDI program’s physician advisor?
  • The other roles of the active and involved CDI physician advisor
  • Review potential physician advisor time requirements and how to get paid

4:30 p.m. – 5:00 p.m.
Open Q&A

5:00 p.m. – 6:00 p.m.
Networking Reception Sponsored by Nuance

Track 2: Expanding and Innovating the Role of the Physician Advisor

James Manz, Vaughn Matacale, Robert Stein, Beth Wolf

7:00 a.m. – 8:00 a.m.
Registration and Breakfast

8:00 a.m. – 10:00 a.m.
Is Your Hospital “Safe?” Patient Safety Indicators Part 1
Robert Stein, Enjoin

  • Patient Safety Indicators (PSI) basics
  • PSIs and CMS quality reporting
  • Hospital Acquired Condition Reduction Program (HACRP)
  • CMS Hospital Compare
  • PSIs and risk adjustment
  • Physician advisor integration into a PSI surveillance program

10:00 a.m. – 10:15 a.m.
Break

10:15 a.m. – 12:00 p.m.
Implementing an Outpatient CDI Program
James Manz, Mayo Clinic

  • Mayo Clinic Experience:  Implementation of an outpatient clinical documentation integrity Program
  • Making the case with risk adjustment and quality
  • Leveraging people, processes, technology
  • Clinical considerations for effective outpatient and ambulatory efforts 

12:00 p.m. – 1:30 p.m.
Lunch (provided)

1:30 p.m. – 3:00 p.m.
Service Line Analysis: Strategies for Success
Vaughn Matacale, Vidant Health

  • How to interpret CMI data
  • Answering the tough questions: “Our CMI is down can you take a look?”
  • Ins and outs of a systematic drill down to identify areas of opportunity (and correct areas of misinterpretation)
  • Case examples

3:00 p.m. – 3:15 p.m.
Break

3:15 p.m. – 5:00 p.m.
Is Automation Your Next Step?

  • Case study from the CDI team at Vidant Health in Greenville, North Carolina, offers insight into how health systems can explore, develop, establish, and refine an automated query process
  • Review CDI needs related to natural language processing
  • Implementation timelines, outcomes, benefits, and pitfalls to overcome

5:00 p.m. – 6:00 p.m.
Networking Reception Sponsored by Nuance



Day 2—Monday, May 2, 2022

7:00 a.m. – 8:00 a.m.
Registration and Breakfast

8:00 a.m. – 10:00 a.m.
Is your Hospital “Safe?” Patient Safety Indicators Part 2

Robert Stein

  • Physician documentation and impact on PSIs
  • Complications of medical care
  • PSI case studies (problematic cases involving respiratory failure and PSI 11, etc.)

10:00 a.m. – 10:15 a.m.
Break

10:15 a.m. – 12:00 p.m.
Optimizing Hospital Performance Data: Small Group Exercise in Mortality Reviews

Trey La Charité

  • Why should healthcare organizations review all in-house mortalities?
  • How to successfully implement a mortality review process at your organization
  • Understand the expected and unexpected results of creating a mortality review process
  • Small group reviews of actual mortality cases for improved diagnosis capture and documentation revision opportunities
  • Understand when discovered documentation opportunities should or should not be added to a mortality record

12:00 p.m. – 1:30 p.m.
Lunch (provided)

1:30 p.m. – 3:00 p.m.
The Power of the Pilot Project

Vaughn Matacale

  • Review of Vidant Health pilot projects--proof of concept on CDI expansion
  • UR, mortality reviews, HCC CDI, post discharge prebill review
  • Effectively leveraging the physician advisor
  • Demonstrating ROI and moving to full implementation

3:00 p.m. – 3:15 p.m.
Break

3:15 p.m. – 5:00 p.m.
You May Be Seated Now: Getting CDI at the Table for C-Suite Discussions
Beth Wolf, Roper St. Francis Healthcare

  • Selling leadership on how CDI benefits the organization—revenue, externally reported quality metrics, research/population health
  • Logistical suggestions for getting your voice heard at the senior leadership level
  • Presenting metrics to senior leadership including proactive identification of opportunities
  • “Be careful what you wish for”—overextension considerations, the importance of making clear asks, avoiding score creep

5:00 p.m.
Adjourn

The Physician Advisor's Role in CDI

Speakers

Trey La Charité, MD, FACP, SFHM, CCS, CCDS, Medical Director for Clinical Documentation Integrity and Coding, University of Tennessee Medical Center

Trey La Charité, MD, FACP, SFHM, CCS, CCDS, is the medical director for CDI and coding at the University of Tennessee Medical Center in Knoxville. A past ACDIS Advisory Board member, La Charité is a regular presenter at the ACDIS pre-conference Physician Advisor Boot Camp. He is clinical assistant professor of internal medicine and curriculum director of the residency program’s hospitalist rotation. A practicing hospitalist for nearly 20 years, he has oversight spanning case management, utilization review, medical records, compliance, and performance improvement.


James Manz, MD, CCDS-O, FAAO, Consultant in Spine and Neurological Surgery, Physician Chair Outpatient CDI Subcommittee, Mayo Clinic Health System

James Manz, MD, FAAOS, CCDS-O, is a consultant in spine and neurological surgery with the Mayo Clinic Health system NWWI. He serves as physician chair of the Mayo Enterprise Outpatient CDI Subcommittee, physician vice chair of the Mayo Enterprise Inpatient CDI Subcommittee, and physician advisor of the Mayo Clinic Problem List Stewardship Committee. Dr. Manz is also a member of the ACDIS CCDS-O certification committee.


Vaughn Matacale, MD, CCDS, Director, Clinical Documentation Advisor Program, Vidant Health

Vaughn Matacale, MD, CCDS, is the director of the physician advisor program at Vidant Health in Greenville, North Carolina. He is building a team of full-time physician and advanced licensed practitioners to provide DRG validation, coder and CDI specialist support, and systemwide medical staff education on CDI and its effect on finance and quality. Matacale served for 10 years as a utilization review consultant and has more than 10 years of experience in hospital medicine, which he continues to practice. He is a frequent speaker for ACDIS, a subject matter expert, and a member of the ACDIS Advisory Board.


Robert Stein, MD, FCCP, CCDS, Medical Director, Physician Associate of MS-DRG Assurance Program, Enjoin

Dr. Stein is a Medical Director for Enjoin’s MS-DRG Assurance program, providing clinical insight and education as part of the pre-bill review process. He earned his CCDS credential in June 2013 and completed AHIMA’s ICD-10-CM/PCS Coder Workforce Training in August 2013.

Dr. Stein is board-certified in Internal Medicine with subspecialties in Critical Care and Pulmonary Disease and has over 25 years in active practice. He was the Physician Advisor for the medical record documentation program at Morton Plant Mease Hospital, part of the BayCare Health System, for over 16 years.

He served as the Director of the Pulmonary Rehab for Morton Plant Mease for 2 years and served in several other administrative roles including Co-Director of the Respiratory Therapy Department for Mease Dunedin Hospital and Mease Countryside Hospital, Co-Director Morton Plant Mease-BayCare Outpatient Center Sleep Center, President of the Medical Staff for Mease Healthcare and served on the Board of Directors for Morton Plant Mease 2003-2009. He was a Clinical Instructor of Medicine at the University of South Florida. He also served as Physician Advisor Quality Management and a Physician Advisor Senior Solutions for Blue Cross Blue Shield. He is an original and current member of the EICU physician team providing telemedicine clinical support for BayCare Health System.

Dr. Stein has provided numerous educational webinars for our clients and physicians focusing on several challenging clinical coding and documentation issues. He has also provided national presentations at industry conferences including AHIMA and ACDIS and authored articles for HCPro’s publications, Briefings on Coding Compliance and HIM Briefings.

Having served as a physician champion, he recognizes the positive impact this has on clinical documentation and coding and uses his experience and expertise to provide valuable education to coders, CDS and physicians.


Beth Wolf, MD, CPC, CCDS, Medical Director for HIM, Roper St. Francis Healthcare

Beth Wolf, MD, CPC, CCDS, is the medical director for HIM at Roper St. Francis Healthcare in Charleston, South Carolina. She is board certified in palliative medicine, internal medicine, and clinical informatics. As a leader, physician, and CDI professional, Wolf improves data reliability and aligns CDI efforts with physician and system priorities. She works with providers to bridge the gap between clinical language and the codified translations.

The Physician Advisor's Role in CDI

Continuing Education

ACCME
HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates this educational activity for a maximum of 14 AMA PRA Category 1 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AHIMA
This program has been approved for 14 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.

ANCC
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 14 nursing contact hours is provided by HCPro. 

ACDIS
This program has been approved for 14 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).

CABRN
HCPro is approved by the California Board of Registered Nursing to provide 16.8 nursing contact hours.

CCMC
This program has been pre-approved by the Commission for Case Manager Certification to provide continuing education credit to CCM board certified case managers. The course is approved for 14 CE contact hours.