Using Technology to Transform DRG Validations
CAVO® exponentially increases DRG audit efficiencies by minimizing your team’s administrative burden and maximizing their coding skill sets.
Using Technology to Transform DRG Validations
CAVO® exponentially increases DRG audit efficiencies by minimizing your team’s administrative burden and maximizing their coding skill sets.
DRG Reviews: Now vs. What's Next
Now: Manual DRG Reviews
Payment integrity coders and nurses determine appropriate DRG for reimbursement by sifting through mountains of paper sent by the provider
Plans have varied processes for verifying— and confirming—the diagnosis billed aligns with treatment during hospital confinement
Next: Search-assisted reviews
Coders and nurses use technology to pinpoint needed information and make decisions 300+% faster—prepay or postpay.
- Prepay reviews: Improved TATs leveraging a pre-defined search library for even quicker decisions and postpay audit avoidance
- Postpay reviews: Trend which savings are realized immediately or extrapolated in future savings
Learn How Common DRGs are Audited Faster with CAVO
Predefined Searches as a Key Functionality for DRG Validation
- Library of 100s of available complex “and”, “or”, and “not” statements designed to efficiently pinpoint DRG validation information.
- Customizable to incorporate payer policies.
Moving to Prepay DRG Reviews
The idea of moving to prepay DRG reviews can seem overwhelming and perhaps even impossible. In this article, learn about some of the top challenges of a DRG review and how moving to prepay DRG reviews can help alleviate them.
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