• Component of CMS-required Fraud, Waste and Abuse programs, which can be presented during CMS audits.
  • Record review findings can support other cost management initiatives such as COB and identification of clinical detail for risk adjustment capture.
  • Corrected procedural coding can be correlated for claims departments to verify physician billing of the same procedure.
  • Provider-specific coding trends can be identified and analyzed, and utilized as a discussion point during contract negotiations.
  • Reduction in appeals stabilizes financial reserves.
Copyright © 2013 – 2018 DRG Claims Management, All rights reserved.