Outpatient CDI

Outpatient CDI
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Storyboard Text

  • Patient Opportunity List
  • Smith, Bill | Diabetic neuropathy type II with hyperglycemia
  • Kline, Robert | Major Depression, recurrent
  • Outpatient CDI
  • Patient: Smith, Bill MRN: H0003432 Opportunity: Diabetic neuropathy type II with hyperglycemia Reason: Reported previous years Evidence: •2/15/2015: DX F33.0 found on claim
  • Send a reminder to the physician
  • Jane reviews the schedule for tomorrow thru the Risk Adjust Rules module
  • Send Reminder
  • Patient: Smith, Bill MRN: H0003432 Opportunity: Major Depression, recurrent Reason: Reported previous years Evidence: •2/15/2015: DX F33.0 found on claim
  • Hi Dr Jones, It appears that Bill Smith was diagnosed with diabetes last year. Can you conduct a clinical evaluation of this condition during his office visit? Thanks! Jane CDS
  • The Outpatient CDI module has evaluated the medical records and previously submitted claim data for tomorrows scheduled cases and displays a list of opportunities Jane select Bill Smith's visit
  • Jane can quickly review the reason and any supporting evidence found by the predictive analytics engine. She pushes the "Send reminder" button.
  • Bill Smith is known to have a history of diabetes
  • Jane researches the medical record to collect further evidence to support this suspected diagnoses
  • Jane enters a brief message to Dr Jones asking him to evaluate this recurring condition during the office visit and sends it.
  • Send
  • The next day, Dr. Jones is conducting his office visit with Bill Smith. He sees the message sent by Jane and is reminded to ask Bill about his Diabetes.
  • He later dictates the office visit into Dragon Medical Advisor. He remembers to mention his clinical evaluation of Bill Smith's Diabetes but leaves out some key specificities.
  • Patient Opportunity List
  • DMA prompts him to add further specificity
  • He dictates or types the specificity into the clinical note
  • Lauren is the billing clerk for Dr. Jones' office. She is working on submitting the claim for Bill Smith's visit.
  • The system has evaluated the clinical documents for his visit and suggests the following diagnoses: J21.9 Acute bronchiolitis, unspecified E0840 Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified
  • Smith, Bill | Suggest codes: •J21.9 Acute bronchiolitis, unspecified •E0840 Diabetes mellitus due to underlying condition with diabetic neuropathy, unspecified Clinical evidence: Progress note by Dr Jones
  • Ron James is the CFO of physician organization. He is able to view a dashboard of his improved ambulatory revenue and a reduction in denials.
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