CDI Opportunities—the Hidden Gem in a Financial Risk Assessment

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Jvion finds providers performing an ICD-10 financial risk assessment that includes a historical claims analysis are benefiting from an unintended output of this approach—targeted CDI opportunities within ICD-9. As a result, they are able to optimize reimbursements even before converting to ICD-10.

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A large number of Jvion’s clients have paid for their ICD-10 financial risk assessment with the ICD-9 revenues that they were able to save through identified CDI opportunities

Performing an ICD-10 financial risk assessment that includes a historical claims analysis is gaining momentum within the marketplace. More providers are realizing the tangible benefits that this solution drives. From understanding the exact impact that ICD-10 will have on future revenues to developing a prioritized plan based on financial risk, these providers have a renewed revenue focus that aligns with the business and helps drive engagement across the organization.

But there is another, unintended positive outcome to an ICD-10 financial risk assessment—ICD-9 CDI opportunities. Surya Vadlamani, CIO from Jvion—a leader in ICD-10 financial risk assessments and historical claims data analysis—explained, “Through the detailed analytics that a historical claims analysis and reimbursement simulation provide, we identify outliers. Digging into these codes, we find CDI opportunities within ICD-9 that we pass along to an organization’s HIM or Revenue Cycle team for their consideration and assessment.”

Many of these CDI opportunities stem from two scenarios. “Often times we find unspecified codes in use that actually have a more specific code available in ICD-9. With an unclear payer payment strategy on unspecified ICD-10 codes, it is all the more important to seek opportunities to move away from unspecified coding in ICD-9, which will only make the transition to ICD-10 easier. We also find the ICD-9 codes that have the largest impact to revenue through our reimbursement simulation. With this data in hand, an acute care provider can start to zero in on potential opportunities to optimize reimbursements even before they covert to ICD-10.”

Surya went on to say that a large number of Jvion’s clients have paid for their ICD-10 financial risk assessment with the ICD-9 revenues that they were able to save through identified CDI opportunities. “This is a great hidden gem that we didn’t anticipate, which helps providers drive immediate value from their ICD-10 financial risk assessment.”

For more information on Jvion’s RevCore ICD-10 financial risk assessment or any of their ICD-10 conversion offerings, please visit http://www.jvion.com.

About Jvion
Jvion is a privately held healthcare compliance technology and services organization with a full suite of tools to enable the ICD-10 conversion. The company serves providers and payers in all phases of the ICD-10 conversion process with a simple value proposition—by using Jvion’s tools and solutions, organizations can do more to reduce cost, mitigate risk, and optimize reimbursements with fewer resources and in a shorter time line. Please visit Jvion’s website at http://www.jvion.com for more information.

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Allison Alavi
Jvion
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