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Since a disease is an insurable event, each DRG represents the average resources needed to treat patients grouped to that DRG relative to a national average.
March, Midwood chairman, and Gail Dudack, DRG managing partner and chief investment strategist, announced.
For medium-sized hospitals (about 100 beds), bronchitis with coexisting complications (coded within DRG 96), pneumonia without organism specified but with comorbidity (included under DRG 89), and congestive heart failure (billed under DRG 127) can represent an annual gap between actual Medicare payments and corresponding billed charges of as much as one-half million dollars.
Michael brings key assets to DRG, as we experience continued expansion in our TIC property portfolio, and look to new opportunities," said Gary DeSanto, Chief Executive Officer of DRG.
The 3M APR DRG Classification System goes beyond basic DRG patient classification to account for a patient's severity of illness and risk of mortality.
DRG Assurance implementation will take place in two phases, with the first phase targeting the five clinical focus areas included in the HQID.
The 3M APR-DRG classification system goes beyond basic DRG classification to account for a patient's severity of illness and risk of mortality.
CC coding rates increased from 2001 to 2002 in 64 of the 99 DRG pairs included in the analysis.
The Health Net Connections DRG claims review program is unique in the industry," said Kelly.
The Benefits Improvement and Protection Act of 2000 requires the Medicare program to make additional payments for certain approved new medical services and technologies furnished under the hospital prospective payment system (PPS) until the DRG (diagnosis related group) system is eventually adjusted to account for the cost of the new technology.
Cost containment services include hospital bill audit, claim repricing, DRG validation, claims audit subrogation recovery, collection and fraud investigation and recovery services.
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