Physician-led DRG validation with 24-hour turnaround

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DRG Validation

Bridging the gap between hospital coders and attending physicians.

Pre-bill DRG reviews are necessary to ensure that effective documentation is used to capture the accurate diagnosis-related group (DRG) and risk of mortality. Accurately capturing the correct DRG in a timely manner is critically important to ensure revenue integrity and to relay high quality care as publicly reported.

All pre-bill DRG reviews are completed by our physician advisors, and based on sound medical evidence. Our physician advisor team includes certified coders (CCS) and certified clinical documentation specialists (CCDS).

  • Our physicians ensure documentation and coding compliance to prevent denials and secure accurate reimbursement
  • DRG review services are backed by our proprietary, concurrent analytics that identify opportunities for targeted physician education
  • DRG validation helps hospitals achieve more accurate patient acuity and increase case mix index (CMI)
  • Clients can get started quickly through our web-based solution with limited IT support required

Contact us to request pre-bill DRG validation services.

Our Services

We break down departmental silos in hospital organizations through the unification of clinical documentation across quality, utilization, denials and CDI.

Physician Advisor Programs

Quality

  • Patient Safety Indicators
  • Hospital Acquired Conditions
  • Mortality Risk Adjustment Optimization

Utilization

  • Status Assignment
  • Medical Necessity
  • Extended Stay Reviews

Denials

  • Peer to Peer Support
  • Appeals Support
  • Contract Review

CDI

  • Documentation Education
  • Case Reviews
  • Query Support

LTAC Documentation

IRF Education

Analytics

Get Credit For The High-Quality Care You Provide!