Clinical Documentation Improvement and Recovery Audit Contractor Prevention

Maxim’s clinical documentation improvement (CDI) solutions address RAC issues and prevention. During the second (evaluation) phase of MHIS’ CDI Process, a sample of your patient population records are identified for the correct ICD-9 and POA coding application and MS-DRG assignment. The records are also reviewed for any RAC documentation risk.

Identification of RAC Risk:

• MHIS reviews documentation in your facility’s records to uncover any documentation gaps and assesses if those gaps could lead to potential RAC denials.
• For those records where RAC-required documentation may be incomplete, MHIS can evaluate for medical necessity risk.

Addressing RAC Prevention:

• During Maxim’s education phase of the CDI process, each RAC risk issue that was identified during the evaluation phase is addressed.
• RAC risk concepts are reinforced during Maxim’s clinical application training and queries to physicians are initiated in accordance with customized documentation clarification requests.
• RAC risk issues are monitored during the on-site follow up record reviews five times during the first year of MHIS’ services.

We invite you to discover what makes Maxim a leader in the HIM and CDI industry. Contact us today to learn more about our comprehensive CDI services.