HDI will review all DRG bills regardless of size or volume. Through the use of our proprietary HealthMark DRG Validation software, each hospital bill claim is scrutinized and electronically evaluated for calculation (when client specific rate tables are provided), coding, or grouping errors.

HDI's HealthMark DRG Validation software program ensures that hospital bills reflect the appropriate DRG code, which is used to establish the correct reimbursement. The process consists of an in-depth review of the patient's medical records to validate the diagnosis and procedures that were used to establish the DRG for the claim being billed. Our proprietary DRG system is comprised of two modules: claims tracking history and DRG analysis. The combined use of client-specific rate tables and customized DRG coding software assures that each claim is accurately reviewed for possible savings potential.

HDI has created a valuable database, HealthMark DRG Validation software, which supports clients across the country with accurate coding and DRG grouping information. Each time a claim is screened, reviewed, or changed, it is entered into our database and the profile for the hospital is automatically updated. This data enables us to monitor many hospitals' coding patterns and focus on DRGs that have historically been a problem.

The DRG review personnel are all experienced coding professionals with formal ICD-9-CM and DRG coding training. The majority of the staff of Registered Health Information Administrators (RHIA) are also Certified Coding Specialists (CCS). Each coding staff member has a minimum of five years of hospital coding experience.

The Results

		Proven savings - $3,475 average per case
		Identification of DRG errors result in significant savings for the client.