I’m consistently surprised at how few CDI or IP coding professionals talk about their most basic job function. The very reason they are hired, and what most do for eight hours a day:

I'm talking about chart review.

Go on Linkedin or Facebook and it’s rarely discussed.

Yet it’s ... everything. Nuanced, complex, clinical, critical to the quality of financial health of hospitals. It’s how patient acuity is expressed in coded data, how hospitals get paid, and why CDI and coding professionals are employed.

I’ve heard it described as akin to detective work, puzzling together the pieces and presenting an informed query to the provider. Yet like detective work it often remains a mystery.

Dr. Tarman Aziz joined me to open up that conversation. He is founder and CEO of CDIQ Consulting, LLC, a physician-led healthcare education and consulting firm focused on closing the gap between clinical reality and coded data. On this episode of #OTR we discuss:

• Is chart review unique to the individual/healthcare organization/assistive tech, or are there underlying principles everyone can follow?
• How evolving clinical indicators in a case drive a concurrent CDI workflow—the differences of reviewing a chart at 24 vs 72 hours as clinical indicators morph
• How early is too early to look at an inpatient chart?
• Underutilized and underrated areas of the health record
• Review strategies for encephalopathy, dehydration, hyper- and hyponatremia, and cerebral edema/compression
• Tarman’s work consulting and educating non-traditional CDI candidates
• The remarkable story of Tarman’s fiancé Anna, an 11-year survivor of Stage 4 breast cancer

And we’re off! The first episode of #OTR of 2026, From Risk to Revenue Clarity: How One Health System Transformed OP CDI Performance.

I continue to beat the drum of outpatient CDI because I believe in it.

Risk adjustment and capitated payments are a superior reimbursement mechanism than fee-for-service. Certainly not perfect, but I believe they are better aligned with keeping patients healthy.

It’s also an exciting new avenue for CDI and coding professionals to work.

Making it work isn’t easy. Success requires new workflows, new metrics, and an even greater level of physician education/buy-in than acute care settings.

We get into all of this on today’s show.

My guest Jason Jobes, SVP of Norwood Solutions, is a whiz when it comes to value-based care, you will be hard-pressed to find a more informed speaker.

Note: You can download the slides referenced on the show here, though they are not needed.

Here we are, our last episode of Off the Record this year.

I hope you’ve had a great 2025.

Just my voice today.

I’m ending with a solocast, a reading/summary of a paper about the biggest news story of the year: The explosive growth and proliferation of artificial intelligence, or AI.

You might recall my poll from a couple weeks ago; you all confirmed it.

Where do people fit with this tech? None of us really know, but I offer my opinion here.