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Get A Free Revenue Cycle Management Assessment

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Capture missed revenue with DRG (Diagnosis Related Grouping) validation services

Streamline DRG audits with enhanced coding skills and reduced administrative burden

Do you want to get 100% reimbursement faster?

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Plutus Health Is A One-stop Personalized solution For All ASC Billing, Coding, And RCM Needs

AAPC-Certified

AAPC certified ASC coders

Denial and AR Management Services

Specialized denial and A/R management services

One Click support

One-click support 24/7* 365 days

Stop compromising your ASC’s revenue performance. Speak to our ASC medical billing and coding specialist today.

Schedule an expert call

Empower your DRG validation using AI technology

Plutus Health’s experts accurately code and submit DRG assessments to the payers. We ensure to remain compliant with state and federal guidelines for coding and billing procedures. Our team helps hospitals get maximum reimbursement and reorganization to which it is entitled

Thorough analysis

Use cutting-edge technology to thoroughly analyze and capture all coding errors that affect severity score and DRG assignment

Comprehensive review

A comprehensive review of clinical documentation, patient demographics, charge entries, diagnosis coding, physician billing, and procedure details

DRG shifts and NTAP

Identify all the NTAP (New Technology Add-On Payment) and DRG shift opportunities to optimize back-end revenue

Process improvement

Leverage AI in DRG validation to maximize benefits and improve CMI (case mix index), compliance, quality, and accuracy

Benefits of Plutus Health’s DRG validation services

Severity level, patient acuity, and professional fees clinical documentation review

Check and update all necessary documentation for appeal preparation

Identify inconclusive or insufficiency for Case Mix Index (CMI)

Provide education on CDI improvement, non-compliance coding practices, and missed coding revenue opportunities

Severity level, patient acuity, and professional fees clinical documentation review

Check and update all necessary documentation for appeal preparation

Identify inconclusive or insufficiency for Case Mix Index (CMI)

Provide education on CDI improvement, non-compliance coding practices, and missed coding revenue opportunities

Connect with Plutus Health to aid your team in working smarter and combat DRG complexities

Schedule an expert call

DRG validation result

100

%

Reviewed Inpatient Case

1.5

-

3

%

Discovery Rate

96

%

Agreement Rate Finding AVG

25

X

Effectiveness

Plutus Health’s DRG validation for maximum compliance, quality, and reimbursement

Plutus Health’s professional coding reviewers have 15+ years of experience and are all from (CCS, RHIT, or RHIA). We appropriately use ICD-10 CM and ICD-10 PCP codes to capture diagnosis. Our team has expertise in the financial and compliance ramification of coding. We have in-depth knowledge of clinical disease processes, coding, physician documentation, and DRG grouping methodology to ensure reliable and accurate audits

  • Pre-pay reviews: Plutus Health helps to improve TAT and provides assistance for quicker decision-making and avoiding post-pay audits
  • Post-pay reviews: We are updated on future trends and compliance to remove penalties and improve savings

Keep updating and evolving for long-term growth with Plutus Health:

  • Comprehensive payment review to catch all unpaid revenue
  • Assistance in upcoding and down coding
  • Optimize coding and documents for compliance and reimbursement
  • Identify and recover unpaid revenue
  • Optimize workflow and current DRG process
  • Identify DRG shifts to avoid rebilling
  • Expertise with all systems like MS-DRGs, IR-DRGs, and APR-DRGs
  • Ensure appropriate reimbursement, accurate coding, and mitigate risk
  • Use appropriate ICD code and SOI (Severity of Illness) and ROM (Risk of Mortality) modifiers

Schedule a call with an
DRG expert

Combat DRG validation challenges and find gaps in your revenue cycle management process with Plutus Health

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