Special Notice / Hearing: None__
Vote Required: Majority
To: Honorable Board of Supervisors
From: Louise F. Rogers, Chief, Health System
Chester J. Kunnappilly, MD, Chief Executive Officer, San Mateo Medical Center
Subject: Agreement with Navigant Consulting Inc. to Provide a Clinical Documentation Process Improvement Program
RECOMMENDATION:
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Adopt a resolution authorizing an agreement with Navigant Consulting Inc. for consulting services to develop a clinical process improvement program for the term May 1, 2018 through April 30, 2021, in an amount not to exceed $840,000.
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BACKGROUND:
San Mateo Medical Center (SMMC) provides medical services to the safety net population within the County, and some of those services are supported by state and federal funding sources. In order to properly bill for reimbursement for such services, SMMC's Resource Management Department (RMD) is responsible for accurate documentation of a patient's medical necessity determination and the clinical services received.
In December 2017, SMMC completed a Request for Proposals process to identify a vendor to provide a Clinical Documentation Improvement program. Navigant Consulting Inc. (Navigant) was chosen because of its innovative approach to patient tracking and medical record documentation. Navigant's technology will effectively supplement SMMC's current processes and ensure compliance with medical necessity documentation requirements, including medical necessity and complete capture of clinical services received.
DISCUSSION:
Due to the complex and evolving nature of state and federal regulations regarding medical record documentation and patient billing, SMMC remains focused on training SMMC providers, as well as RMD and Coding Department staff, to improve and ensure the accuracy of medical record documentation, monitoring, and reporting. These processes will reduce the number of appeals and denials due to documentation issues.
The agreement an...
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