DRG Validation

Healthcare organizations face increasing regulatory compliance issues. Clinical coding and documentation requirements often overwhelm healthcare systems and lead to significant revenue leakage. Each year, hospitals are underpaid between 1-5% of Net Patient Revenue despite significant investments to mitigate revenue leakage.
Our Solution

• Revint’s powerful automated DRG Validation solution is the first of its kind to combine both technology and hands-on auditing

• This web-based, fully HIPAA-compliant solution utilizes rules-based algorithms that target potential coding anomalies and/or documentation improvement opportunities at the time of coding completion

• Solution is backed by Revint’s experienced auditing staff who performs the heavy lifting of the review by providing supporting documentation from the client’s medical record, along with industry-recognized references (coding conventions/guidelines, AHA Coding Clinic advice, etc) to support the recommendations for DRG revision

• The final decision on the DRG shift is always made by the client. Intuitive interface allows your staff to easily review recommendations and quickly make a decision

• Pre-or post-bill options

• Limited IT involvement

• Solution serves as an educational tool to increase CMI, accuracy, compliance, and quality, through dashboards, reporting, and closed loop feedback

DRG Validation

Results

Revint’s proprietary solution is 20 times more efficient than traditional auditing services alone – allowing you to review 100% of inpatient DRGs instead of a sampling – and in time to recover your missing revenue from payers.

DRG Validation

Experience

Often, private and academic healthcare systems have implemented Revint’s DRG Validation solution in the context of computer-assisted coding and clinical documentation software solutions. Upon start-up, healthcare organizations typically experience incremental reimbursements and CMI improvements within just the first month.

DRG Validation

Value

Revint offers contingency-based and fixed-fee agreements. Fixed-fee agreements are guaranteed at 2 to 1 – ensuring limited financial risk to your organization. In addition to limited risk, our DRG Validation solution requires minimal IT involvement from your organization.

Discover More Solutions

DRG Validation

Revenue Assurance

Suite

Assures the episode of care was coded, charged, and discharged accurately for optimized reimbursement

Payer Accountability

Suite

Ensures the claim was processed correctly and recovery was optimized for expected reimbursement

Medicare Reimbursement

Suite

Validates that your organization was appropriately reimbursed for the population you serve