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Are you facing the challenge of keeping up with the volume of DRG downgrade reviews and appeals?

 

Don't worry, we are here to help! Introducing our comprehensive hospital DRG downgrade review and appeal services designed to assist hospitals in managing the review and appeals process and recovering revenue to which you are entitled.

Benefits of Partnering with Us

  • Increased Success Rates: Our expertise and attention to detail significantly enhance the chances of overturning DRG downgrades, leading to increased revenue for your hospital.
  • Time and Resource Savings: Engaging our services allows your staff to focus on patient care while we handle the intricacies of the appeals process, saving you valuable time and resources.
  • Long-Term Solutions: We work with hospitals to implement strategies that reduce the occurrence of future downgrades, ensuring sustained revenue optimization.

Why Choose Our Services

  • Our process - Our experts will review your all DRG downgrade cases, identify potential areas of appeal, and provide an initial assessment of the likelihood of success. Our comprehensive review process includes a coding and clinical review.
  • Appeal Preparation: We meticulously gather all necessary medical records, review documentation, and develop compelling arguments to present strong appeals on your behalf.
  • Expertise: Our team consists of highly skilled and experienced professionals who specialize in hospital DRG downgrade appeals. Our clinical appeal team includes RNs that were previously employed by payer clinical audit contractors.
  • Strong overturn rates: By utilizing our services, hospitals can strengthen their appeal cases, leading to a higher success rate in overturning DRG downgrades. This directly translates into an increase in revenue for your hospital.
  • An Approach to meet your needs: Every hospital has its unique challenges, and we tailor our services to meet your specific needs. Weather your hospital is looking to outsource the complete process or is just looking for an overflow vendor, we can meet your needs.

 

 

Stacy Pereira

Stacy Pereira

spereira@cbiz.com | 609.918.0990