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Many people feel that physicians and payers are at opposite ends of the spectrum when it comes to reimbursement. I confess that I felt that way for many years, but of late, I have noticed greater and greater alignment of interests and goals. There is certainly is a great overlap when it comes to clinical documentation improvement (CDI).

Payers want accurate and complete data, and bills that match what is documented on the chart. Providers want to be fairly compensated for the resources they expended in caring for the patient, whether that is from a prospective payment plan like Medicare, or per diem reimbursement (as is still used by many payers). The common thread that runs through all this is clinical documentation. If the severity of illness, conditions, and co-morbidities are not fully documented, providers and payers are going to be butting heads.


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