CASE STUDY
Health System — 7 hospitals, physician groups, surgery, dialysis & rehabilitation centers
Substantially improve reimbursement accuracy and quality with Conifer’s Clinical Documentation Improvement (CDI) solution
How We Helped:
- Structured CDI education program, including new-hire orientation and boot camp – monitored progress with quality audits
- Increased CDI collaboration with Coding and Quality departments, including DRG reconciliation and mortality second-level reviews
- Improved provider engagement and education, including established physician champions
7%
INCREASE IN MEDICARE CASE MIX INDEX (CMI) CAPTURE
10%
INCREASE IN COMMERCIAL PAYERS CMI CAPTURE
24%
INCREASE IN CDI STAFF PRODUCTIVITY
Accelerate Revenue Capture. Ensure Accurate Documentation. Reinforce a Compliance Culture.
Our Clinical Revenue Integrity solutions serve as a foundation for accurate, compliant documentation and revenue generation. Whether you are looking to improve quality and compliance, build stronger physician relationships, or transform your organization into an innovative leader, we can help.
Manage coding quality and accuracy in changing regulatory requirements
Conifer Health’s Coding & Coding Quality solution delivers exemplary coding in every major specialty leveraging transparent, actionable insights in performance, quality, productivity and opportunities for process improvements.
Our solution includes:
- 100% AHIMA or AAPC credentialed coders and best-in-class coding education program
- Inpatient, outpatient, E&M leveling and professional fee services
- Consistent, unbiased coding quality and compliance program
- Advanced anomaly detection, predictive analytics and accurate data improves turnaround times
Key benefits:
- Natural Language Processing enhances coding accuracy with Computer-Assisted Coding
- Coding quality scores higher than the industry average
- MicroSegmentation® automatically routes high-risk encounters to help eliminate preventable denials
- ConiferCore Business Intelligence® pinpoints areas of risk and potential coding issues
Outcomes:
- 98% achieved coding quality
- 53% reduction in DNFC days
- 97% accuracy in ED charging/coding
Prevent revenue leakage with proper charging behaviors
Conifer Health’s Revenue Integrity solution provides you with a comprehensive strategy that ensures compliant, transparent and defensible revenue-generating processes.
Our solution includes:
- Charge Description Master (CDM) management with charge accuracy audits
- Ongoing education of charging protocols
- Defensible and transparent price modeling
- Predictive analytics to prevent missed charges
Key benefits:
- Machine Learning to manage large account volume and complex charge audits
- Charge Description Master Strategic Pricing Analytics maximizes price-sensitive net revenue
- Advanced analytics system built on peer data to identify charging trends
- Executive dashboards that provide easy data analysis
Outcomes:
- 7 Days CDM requests turnaround time
- 100% Automated Account Review for Charge Capture
- 53% late charge percent
Ensure complete and detailed documentation
Conifer Health’s Clinical Documentation Integrity solution supports critical reporting for clinical quality and accurate and appropriate reimbursement.
Our solution includes:
- Operations management and consulting
- Customized Physician education, training and engagement
- Workflow and technology optimization
- Quality audits and skills assessment
Key benefits:
- Documentation reviews that pinpoint errors, leakage, root causes and improvement opportunities
- 7-10% improvement in case mix index
- Machine learning and AI reduce the need for human intervention
- 150+ physicians, nurses and credentialed coders certified in complex coding
Outcomes:
- 30% improvement in physician query agreement rate
- 96% average physician response rate
- 98% accuracy average query
Provide essential patient information privacy and security
Conifer Health’s Health Information Management solution focuses on leading the advancement of informatics, data analytics, and information governance while supporting complete, accurate and secure medical information.
Our solution includes:
- Management of the legal health record
- Diligent eMPI, data integrity, transcription management and release of information
- Predictive and prescriptive data analytics
- Support compliant regulatory requirements
Key benefits:
- Efficient HIM process that supports timely and accurate coding results
- ROI technology that provides automated optical review of patient records to ensure quality of disclosures
- Best practice models – workflow prioritization and improved privacy and security protections
- Excellent Outcomes with transitioning and transforming Large Health Systems
Outcomes:
- <1 Day Average ROI Turn Around Time
- 99% Document Imaging Accuracy
- 8% Rate reduction over contract term
