Ms. Peters has served a variety of healthcare clients including multihospital systems, complex academic medical centers, large urban hospitals, and small community hospitals. She is a noted speaker and most recently spoke nationally on CDI.
Ms. Peters has implemented numerous CDI initiatives across the United States. She previously functioned as the senior project director for a large, multisystem hospital, where she helped develop an innovative executive dashboard to track and measure the success of the CDI. She designed and delivered sales presentations to potential clients. She developed proposals and project plans to target specific practice improvement initiatives. She also analyzed historical billing data and formulated projections for their return on investment (ROI). She assessed opportunities by reviewing concurrent and retrospective medical records to determine opportunities for improved clinical documentation and determined which type of program would work best. She developed a broad knowledge of conditions that had the potential to impact severity of illness (SOI), risk of mortality (ROM), length of stay (LOS), and diagnosis-related group (DRG) assignments. She assessed needs and developed appropriate education for C-level administration executives, physicians, nursing staff, case management, ancillary departments (wound care, dietary, respiratory therapy, speech therapy, occupational therapy, physical therapy), and inpatient coding staff. She assisted with the development of job descriptions for clinical documentation specialists and physician champions or physician liaisons.
Ms. Peters has trained, mentored, and coached clinical documentation specialists (inpatient/outpatient coding professionals and RNs) on the concepts of IPPS (inpatient prospective payment system) DRG reimbursement, appropriate and compliant documentation, severity of illness, and risk of mortality in the acute care setting. She has developed policies and procedures for clients’ CDI programs. She has performed data entry using a variety of software tools to accurately capture the impact of a CDI program, has reviewed the outcomes data, and has presented to project managers and C-level administration executives to ensure sustainability of their programs. Ms. Peters has experience with MS-DRGs and APR-DRGs.
Ms. Peters has broad experience with professional fee coding, billing, and documentation. Her areas of specialization include ophthalmology, internal medicine, family practice, neurology, and surgical specialties. She provided extensive educational sessions on evaluation and management guidelines to both teaching and non-teaching physicians and their billing staffs across the country. She has conducted ICD-9-CM, CPT-4, and HCPCS Level II coding audits of physician practices to verify appropriate code assignment and reimbursement, and to analyze operational procedures and fee schedules.
Ms. Peters developed a CDI training manual for Medicare Advantage hierarchical condition categories (HCCs). She has performed compliance reviews for physicians’ practices subject to Medicare’s Teaching Physician Guidelines and has provided corrective one-on-one training for physicians. She has conducted emergency room coding reviews for professional components, including post-review educational sessions. She has developed and assisted in the redesign of superbills/encounter forms to facilitate more efficient data-capture processes. She has conducted evaluation and management coding and documentation assessments for family medicine, internal medicine, pediatrics, dermatology, emergency medicine, surgery, obstetrics/gynecology, gastroenterology, neonatology, ophthalmology, and pain management.
Employment History
Navigant Consulting, Inc.
Director
2006 – 2011
HP3
Director
2002 – 2006
PricewaterhouseCoopers
Senior associate
2000 – 2002
QuadraMed Corporation (formerly Cabot Marsh)
Senior consultant
1998 – 2000
HealthCare Consultants of America
Senior consultant
1997 – 1998
Credentials
American Academy of Professional Coders
CPC, CPC-H, CPC-I
American Health Information Management Association
CCS-P, CDIP
New Mexico Health Information Management Association
CCS-P, CDIP
American Association of Clinical Documentation Specialists
CCDS
