Rhonda McClain

Clinical Documentation Integrity Specialist @LCMC Health

Survey physicians regarding their preferred means of communication (email, rounding, focus chart review with one on one consultations) to make sure they are engaged in the process of responding to queries. • Develop a rapport with each physician and/or physician group by providing a precision documentation audit. The purpose of the audit will show them their documentation habits and how they can approve specificity and reduce the assignment of unspecified diagnoses and ambiguous procedures for inpatient and outpatient services. Also, this will serve as a personal benefit for their billing practices. • Educate physicians, coders and other healthcare partners regarding- readmission reduction, value based purchasing (VBP), core performance outcomes, documentation risk like hospital acquired condition (HAC,), patient safety indicators (PSI), recovery audit contractors (RAC) and analysis of Pepper Report. • Establish and query for clinical indicators for target SOI/ROM, MCC/CCs and principal diagnoses to ensure diagnosis validity. • Support coding staff by being proactive with coding challenges. Trend and find solutions for medical necessity edits for both inpatient SMART and outpatient claim edits. Reconcile working MS-DRG verses discharged MS-DRG and provide education when theirs is a MSDRG mixed match. • Develop CDI physician training for established staff and on-boarding of new physicians by working with Coding Educator/Auditors. • Review and Report key performance indicators to trend short falls like non-response queries. • Participate in outpatient CDI efforts. • Assist with audits and appeal.