Improving Clinical Documentation Improvement (CDI) Efficiency

Lima Memorial Health System struggled with coding and CDI processes; HIM manager Tiffanie Mavis said, "We needed better accuracy, reporting, tracking, and a more efficient process" after "using disjointed products and manual, time-consuming processes." The organization implemented "Optum® Enterprise CAC and CDI 3D" to address these issues. Mavis reported that "In the first month, our medical necessity denials decreased by 37%," along with improved clean-claim rates and reduced rework from getting documentation right the first time; no baseline metrics or detailed methodology are given beyond this first-month comparison.

Optum is UnitedHealth Group's data and analytics arm, with one of the largest raw claims and EHR-derived real-world-data footprints of any vendor in this directory.

This sits in the Data Providers stage of the AI use-case lifecycle: Named examples from the real-world-data, claims and competitive-intelligence providers pharma AI systems are trained on, benchmarked against, or run inside of.