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
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:
Schedule a call with an
DRG expert
Our happy clients
Plutus Health’s DRG validation helped us to streamline documentation and coding. We have optimized our compliance and reimbursements with their expert assistance. Plutus Health’s experience and team of certified coders were always available for assistance.
