variences

julie.cruz-sje

As a new CDS, my manager said my cc/mcc/DRG capture numbers are good, but the cash variences are lower than expected. We are going to go over some reports next week.

What are some of the reasons I would see a decrease in cash variences if my capture rates seem approp? Would like to go into this with some knowledge of how to recognize what I may be missing.

Any thoughts, advice or suggestions would be greatly appreciated!

Thanks!

Julie Cruz, RN, CDS
St. Joseph Hospital
Eureka, CA 95501

lspryszak

Could you explain how the "cash variances" are measured? This would help me give you a better answer.

If you are calculating additional revenue based on starting and final coded DRGs, then the variance may be a discrepancy between these two relative weights. What is your process for validating your beginning and ending points?

I really discourage this type of ongoing measurement since any potential additional revenue is just "funny money". What a facility actually receives for a case depends on several things: 1) if it's a transfer DRG you split the reimbursement with the receiving facility (so can't calculate revenue based on starting/ending DRGS). 2) You need to know the discharge status. Again, you might not actually receive the whole DRG payment.

I haven't see a facility yet that drills down this deeply when calculating additional revenue from CDI. That's why this figure is SO subject to variability.