Improving Data Quality and Reimbursements – Ciox Health and Christus Spohn Health System

CHALLENGE: Improve Quality of Coded Data

CHRISTUS Spohn Health System (Spohn), a six campus system in four South Texas cities, provides health care services to the residents of 12 counties in the Coastal Bend. With an opportunity to improve quality of coded data for reimbursement, public reporting, and clinical decision making, Spohn wants to provide education and training to its coding staff across the system.

SOLUTION: Ciox Coding Quality Review & Coding Education

To improve data quality, Spohn chose Ciox to support routine coding and documentation quality review, and coding education to achieve its goals. The solution that Ciox and Spohn implemented included:

  • Baseline review of coding and documentation quality to identify areas for improvement
  • Customized post-audit education to staff through face-to-face, one-on-one training and remote educational sessions using Spohn’s records
  • Ongoing reviews on audit-identified topics to monitor performance and provide additional tailored educational support
  • Focused reviews to understand coding compliance and skills related to “hot topic” reimbursement areas

Results

Ciox continues to help Spohn improve its overall data quality and individual coder skill level with routine coding and documentation quality audits and customized education. Highlights of our efforts include:

  • An overall improvement in data quality of 8%, from an average baseline of 89% to 97%
  • An improvement in revenue capture of millions of dollars
  • Improved coder satisfaction and skill

At a Glance

CHRISTUS Spohn Health System is South Texas’ largest charity care provider and not-for-profit health care system consisting of six hospital campuses – CHRISTUS Spohn Hospital Corpus Christi (Shoreline, Memorial and
South), CHRISTUS Spohn Hospital Alice, CHRISTUS Spohn Hospital Beeville and CHRISTUS Spohn Hospital Kleberg (Kingsville). The health system is consistently ranked as a leading health system in the area and has received national recognition for several pioneering programs, including cardiac care, clinical excellence
and oncology. For more than 100 years, CHRISTUS Spohn has been distinguished by its high caliber staff and affiliated physicians, its comprehensive and innovative services, and its long history of responding to
the needs of the community it serves.

At CHRISTUS Spohn we needed to improve the quality of coding and documentation throughout our system hospitals and sought to partner with a health information management firm who could quickly provide the
high-quality medical coding auditing, education, and training that would make a real difference.

Scott Merryman

Chief Financial Officer

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