CASE STUDY

Improving Query Compliance: An In-Depth Review of e4health’s Audit Proficiency
Table of Contents
2
3
Table of Contents
2
3

The Challenge

Senior leadership at a large health system faced a critical challenge: ensuring the appropriateness of provider responses to Clinical Documentation Improvement (CDI) queries. The goal was twofold—confirming compliance and identifying educational opportunities to enhance the Case Mix Index (CMI). Compounding this challenge was a comprehensive overhaul of the CDI program in the previous year, necessitating a thorough review of staff performance post-revamp.  

The e4health Solution

e4health stepped into the fray with a targeted 150-chart audit, meticulously evaluating query compliance and the suitability of provider responses. The audit had a laser focus on pinpointing overlooked CDI query opportunities—vital for maintaining the accuracy and integrity of clinical documentation.  

Results and Insights

The results of the audit were illuminating. This customer recorded an estimated $28,000 in potential financial opportunity. The provider appropriate response rate stood at 83%, while the query compliance rate was over 60%. These metrics not only reflect the financial prudence of the initiative but also underscore the high level of engagement and accuracy in provider responses. 

These insights are integral to our ongoing mission to empower healthcare providers with data-driven strategies that enhance productivity, quality, and financial outcomes. By identifying the strengths and areas for improvement, e4health and healthcare systems can work together to foster a culture of continuous improvement and excellence in healthcare documentation.  

Conclusion

This case study underscores e4health’s relentless commitment to empowering healthcare providers through innovative solutions and expert guidance. The collaborative effort led to tangible improvements in query compliance and CDI processes, cementing e4health’s role as a steward of excellence in health outcomes through data accuracy and integrity. 

How Can We Help?

For nearly two decades, e4health has been redefining the standards for Clinical Documentation Integrity. The e4health CDI Team is here to cater to all your CDI needs, including Inpatient and Outpatient CDI staffing, auditing, assessment, education, and CDI consultative services. Schedule a call today with our CDI Leaders who are eager to address your concerns and simplify your tasks.