DRG Compliance
Perform a retrospective or prospective DRG review of a sample of claims and
the corresponding medical record documentation
Perform an identical review of a sample of claims assigned within the 10 "Transfer DRG" categories
Review all Diagnosis Coding for correct assignment of Primary Diagnoses
Review all diagnosis coding for correct assignment of Secondary Diagnoses
Assure medical record documentation supports all coded diagnoses
Claim Denial, Suspend and Reduction reviews to assess problem areas and identify solutions as well as preparation of Re-submissions and Payer Appeals
Coding: per diem and "backlog" coding services available by AAPC certified coders
Our Coding Helpline to answer coding/billing questions is available with a 24 hour response time in most cases.
A "Shadow Review" service for Third Party Payer "Medical Claim Reviews" is available as an add-on or stand alone engagement.
Documentation & Charge Capture Templates
Litigation Support in Medicare
fraud/abuse actions
Seminars on documentation and
diagnosis coding for clinicians; includes focus on revenue optimization and
prevention of overpayment through correct diagnosis selection, documentary
support and resulting accurate DRG assignment
Seminars for coders on diagnosis coding and correct assignment of primary and secondary diagnoses; inclusion of all co-morbid and co-mortal diagnoses and includes focus on revenue optimization and prevention of overpayment through accurate DRG assignment
Billing seminars on DRG reimbursement.
"Update Seminars" are available; focusing on regulatory change
All seminars are available on videotape
Additional services available