Learn How to Combat Denials and Avoid DRG Downgrades
Payer strategies are evolving quickly, and healthcare organizations must stay alert to make the most of revenue opportunities, but also to control claims denials.
Will you over react and implement strategies that can unnecessarily constrict your revenue or will you prepare by consolidating an optimal approach, grounded in best practices? These questions must be asked, because based on our recent experience, facilities are vulnerable.
In this paper, Sandra L Brewton, RHIT, CCS, CHCA, CPC, AHIMA-Approved ICD-10-CM/PCS Trainer and Laurie McBrierty, MLT, ASCP will discuss why it is vital to follow best-practice strategies in DRG coding to ensure your organization is meeting today’s guidelines and to prepare for FY 2018. Considering recent denials and DRG downgrading by payers, how your organization adapts will profoundly affect your reimbursements. An organization’s own internal review can set the stage for monitoring and remediating any inappropriate downgrading of DRGs by the payer.