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Prospective Review with MDINFORM
What is Prospective Review?
Limitations of Retrospective Review:
- Focuses only on what’s written in the current chart
- Lack of a Feedback Loop
- No correction – No Learning
- Uncorrected Stays uncorrected forever
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- Clinical Auditors focus on HCC’s that are “not in the chart”
- These potential HCC’s are conditions that are either:
- Not documented in the current year, or
- Not documented in sufficient detail to meet the required threshold for HCC
scoring
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MARA’s Solution:
- Analytics to identify probable errors and omissions
- Patient-Specific education for doctors
- Self-correcting feedback loops
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Utilizing a unique set of algorithms in the data
collection and analytical process, MDINFORM can identify which members
are most likely to have documentation errors
Then, during the chart-review process, our Clinical
Auditors use the MLP Laptop Coding Tool to record any opportunities for
improving documentation
These suggestions are in the form of clear,
concise “bulletins” that, when combined with the patient appointment
schedule, tell doctors only the essential information they need, at the
time they need it. It is Patient-Specific education for doctors.
Why MDINFORM?
- Timing – Doctors see the bulletins just in time to review the chart
before the visit
- Workflow – Bulletins arrive at the Point of Service (when doctor meets
patient)
- Guidance – Our recommendations points just toward probable HCC diagnoses
with guidelines for accurate documentation (always with deference to the
doctor’s judgment)
MDINFORM can also Monitor Compliance and Give Feedback to
Outliers (and it is accessible by Physicians with or without an EMR)
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