Clinical Documentation Integrity Management Services

The Nassau Health Care Corporation is seeking proposals from qualified vendors to provide Clinical Documentation Integrity management services. The goal of this Request for Proposals (RFP) is to secure accurate, efficient, and compliant CDI services that strengthen NuHealth’s documentation practices, support accurate coding, and ensure alignment with clinical and regulatory requirements, while advancing the organization’s mission of delivering high-quality, accessible patient care and ensuring financial sustainability. Key services include: • Conducting concurrent chart reviews to ensure documentation accuracy, completeness, and compliance with coding and regulatory standards. • Validating Severity of Illness (SOI), Risk of Mortality (ROM), and DRG assignment through compliant documentation practices. • Issuing provider queries to clarify clinical indicators, diagnoses, and procedures. • Supporting mortality, readmission, and quality reporting initiatives. • Collaborating with coding staff to ensure integrity of final coded records. • Conducting retrospective and concurrent reviews to ensure accurate HCC capture and risk adjustment. • Focusing on high-risk specialties such as cardiology, oncology, and emergency medicine. • Identifying and addressing documentation gaps contributing to denials or underpayment. • Supporting pre-bill reviews for targeted outpatient service lines. The agreement between NHCC and the successful Proposer will be for a three (3) year term, with automatic one-year renewals thereafter, subject to termination provisions.