BR Healthcare Services provides an ongoing review of facility inpatient coding through its affiliate, DRG Solutions. This review is for compliance purposes, providing an outside entity's perspective on hospital coding, prior to billing, and making concurrent recommendations to assist the facility in maintaining compliance. DRG Solutions provides monthly and quarterly concurrent reviews of the facility's coding. It evaluates the coding for accuracy and recommends changes to help the hospital maintain compliance. This service is offered via fax and mail and through on-site visits depending on the size and complexity of the client.
It is the policy of DRG Solutions that all coding consulting reviews and recommendations will be based upon the medical record documentation received from the participating hospital. All reviews are in accordance with the ICD-9-CM Official Guidelines for Coding and Reporting. The client will have the final decision on all consulting recommendations.
Quarterly reports will be provided to the facility outlining progress on recommended changes. A financial report will also be provided quantifying the results of the service and detailing the cumulative impact of the optimization program since its initiation.
Coding Validation Sample Results
Charts Validated 6,556
Recommended Coding Changes 643
% Coding Changes 9.81%
Increased Reimbursement $882,000
Add’l $s per Coding Change $1,372.00
Add’l $s per Discharge $135.00