As the cost of inpatient care continues to rise, improving payment integrity for these claims has become a paramount concern for health plans. However, a significant number of these plans exclusively employ post-payment reviews, which can introduce obstacles in the process of reclaiming funds from overpayments and result in both provider dissatisfaction and member discontent.
That’s why one regional plan partnered with Cotiviti to implement prepay DRG review, which is designed to complement retrospective paid claims approaches while increasing recovery rates, elevating medical record receipt rates, and reducing administrative costs by as much as 15%.
Read our new case study to learn how prospective DRG review:
- Reduces errors and helps ensure correct payments
- Delivers higher recovery rates and cost savings
- Streamlines processes and reduces administrative burden
Discover how Clinical Chart Validation can benefit your organization and provider network by enhancing the efficiency and effectiveness of DRG reviews without compromising on quality.
