Home | About us | Services | Case Studies | BIA | Careers | Media Center | Contact Us
re|transfer
Transfer DRG Review
Immediate Cash
Other benefits include:
- Identify additional reimbursement on TrDRG’s
- Improved payment accuracy
- Retrospective cash collection
- Sustainable results prospectively
- Peace of mind
Challenge
Many times a patient should receive post acute care and is discharged based on this recommendation from their physician. Medicare pays a reduced DRG payment based on the assumption that the patient will comply with the physician’s recommendation. When a patient, for whatever reason, does not follow through in receiving post acute care, your facility is entitled to the full DRG payment.
Facilities have no way of knowing that a patient did not follow through and that they should have received the full DRG payment from Medicare. Using a proprietary software with algorithms to check admissions and other medicare payments for each TrDRG patient, re|transfer identifies and assists with rebilling of retroactive claims and continues to verify payments are not missed on a go forward basis.
IT support is minimal and the service is provided on a contingency basis with no up front fees.
Methodology and Solution
- Identifies Medicare accounts that have a discharge status inconsistent with claims data
- Improves accuracy of claim payments for designated transfer DRG's
- Validates and documents that patients received post acute care
- Provides a conclusive list of claims that require review for possible rebilling and/or appeal
- Assistance with billing or re-billing of identified accounts
- Reporting demonstrates program’s effectiveness
- Monthly reporting on account statuses and identified issues