Top priorities for healthcare executives today include stabilizing the revenue cycle and cash collection, as well as ensuring adequate cash flow. To make progress on these priorities, many organizations are turning to technologies like artificial intelligence to improve clinical documentation and enhance revenue integrity.
Complete clinical documentation can reduce payer denials, improve financial stability, and benefit hospitals and health systems in other important ways.
To learn more about best practices for deploying technologies that improve clinical documentation, Becker's Healthcare recently spoke with Geoff New, senior vice president of clinical documentation at CorroHealth.
Robust clinical documentation reduces risks for hospitals + health systems
More complete and accurate patient records are the key to streamlining revenue cycle management and boosting economic performance.
"Clinical documentation programs lead to better coding and billing, which reduce claims denials and increase reimbursement rates," Mr. New said. "These initiatives can mitigate financial losses by improving important metrics like DNFC, discharged not final coded, and DNFB, discharged not final billed. Everything starts and ends with clinical documentation."
In addition to the financial implications of clinical documentation, hospitals and health systems face other documentation-related risks such as regulatory non-compliance and audits.
"In the past, some organizations didn't pay as much attention to claims denials and legal compliance, especially in the pre-COVID era," Mr. New said. "Now, organizations need every dollar they can get their hands on. In addition, audits aren't going away. Turning a blind eye will only expand these risks."
Leading organizations create strategic plans and leverage tech to improve clinical documentation
Developing a strategic plan is an effective way to prioritize investments in clinical documentation initiatives. This requires leadership support from the C-suite. "Most chief medical officers are engaged in clinical documentation and the revenue cycle," Mr. New said. "They're interested because it matters to quality metrics, patient engagement and satisfaction, and denials."
When pursuing innovation, the first step is to reflect on where the organization currently stands with clinical documentation. "This can be challenging, but once hospitals and health systems recognize that they need to do something, it becomes easier to start moving forward," Mr. New said. "A lot of organizations put their strategic plans on hold a few years ago, but we are seeing teams pick their plans back up."
In some cases, investments may be required to shift the culture. In other instances, organizations may need a more robust technology infrastructure or additional human resources that know how to use analytics and other outputs from technology solutions.
Strategic plans are essential when mapping out methodical investments in technology for clinical documentation improvement that will have a positive effect on reimbursements and financial success.
"If organizations implement too much technology too fast, it can create a technology overload," Mr. New said. "This can have a negative impact on reimbursements. Each organization must understand where they are when it comes to technology adoption. It's important to determine whether providers and physician groups are ready to use advanced analytics and AI tools like large language models or natural language processing."
A culture of continuous improvement integrates staff expertise + technology solutions
A best practice is to make targeted technology investments based on a health system's existing technology infrastructure and workflows. AI-based solutions are constantly learning and can target clinical documentation improvements that will improve compliance and reduce denials.
"Staffing is something every organization struggles with today," Mr. New said. "Technology can reduce clinical documentation errors and catch things that humans overlook. It places information in the hands of caregivers and front-line staff at the point of need, maximizes reimbursements, and helps to sustain an operating model that was difficult to imagine two years ago in the revenue cycle space."
From a provider perspective, AI solutions can reduce the administrative burden of clinical documentation by streamlining workflows and eliminating repetitive tasks. Technology can also help hospitals and health systems issue accurate claims to payers the first time.
"There are many opportunities to mitigate denials on the front end through registration, utilization review, coding and billing processes," Mr. New said.
Partnerships can ease the clinical documentation improvement journey
When it comes to clinical documentation, partnerships can help organizations deal with concerns related to technology, staffing, processes, and more.
"It's OK to ask for help, and it’s beneficial to choose a partner to join you on the journey," Mr. New said. "Hospitals and health systems don't have to do this alone. It's important to be selective and conduct due diligence. You want to select a partner that you can trust and that won't just try to add more technology to solve problems."
CorroHealth creates true partnerships by meeting healthcare clients where they are and focusing on the problems that need to be solved.
"We never want to be just another vendor that comes in to sell you what we have," Mr. New said. "It's all about the partnership. When I talk to clients about the revenue cycle, I can relate to what they're going through. I know what it means to miss numbers, to have a DNFC that's going through the roof, or a denials rate that's out of control. We want to fix your problem today and then grow with you."
CorroHealth's technology solutions are agile enough to integrate with existing EHR systems and other solutions. In addition, CorroHealth provides education to support a culture of continuous learning.
"It's not a one-and-done journey," Mr. New said. "Continuous learning is essential for physicians and providers, as well as the nursing staff and ancillary team members that focus on clinical documentation. We understand key metrics, patient quality outputs, and patient satisfaction. Optimizing clinical practices can improve operational effectiveness, as well as patient care."
Clinical documentation and the revenue cycle are more important than ever. The COVID-19 pandemic highlighted where gaps existed in these processes. With a partner like CorroHealth, hospitals and health systems can address these issues by deploying technology in ways that are tailored to their unique needs. The results are greater financial stability and regulatory compliance, as well as higher-quality care and patient satisfaction.