Transfer DRG Review

Transfer DRG Review is a solution which monitors Medicare and Medicare Advantage accounts and identifies where hospitals and healthcare providers were underpaid for reasons outside of their control. Through the use of proprietary technology, Auditz determines where hospitals received a transfer DRG payment instead of the appropriate and higher full DRG payment. A common cause for this underpayment is patients often receive post-acute care treatment in a different manner than was anticipated by the hospital when discharged.

Transfer DRG Review projects begin by reviewing the prior four Medicare fiscal years and continue with ongoing monitoring. Auditz reviews all Medicare and Medicare Advantage accounts on behalf of hospital clients, regardless of size or DRG. Through the development of a multi-step follow up process, Auditz is able to verify and document all accounts where the post-acute services delivered fall outside of the post-acute care transfer rule. Transfer DRG Review is a complete turnkey solution with Auditz performing all necessary re-billing and appeal functions off-site. In addition to reimbursement opportunities, Auditz helps identify trending and root cause analyses as well as RAC exposure.

Features

  • Review all DRGs for up to four Medicare fiscal years
  • All re-bill and appeal work is done by Auditz, completely turnkey
  • Excellent results working behind other vendors
  • Both contingency and subscription fees available

Benefits

  • Increase Medicare / Medicare Advantage reimbursement
  • Conduct retrospective review and ongoing monitoring
  • Project occurs remotely with no disruption
  • Turnkey service means no resource strain