DRG and APC Compliance Review Programs
MARSI´s DRG and APC Compliance Review Programs are designed to review 100% of the DRG reimbursed discharges and a representative sample of APC reimbursed discharges. The Programs may be provided separately or together depending on the needs and wants of the facility.
MARSI's team of physician and coding professionals work together to concurrently review the transmitted medical records for clues that a more/less comprehensive diagnosis or treatment process may have occurred. Our concurrent programs allow all recommendations to be transmitted back to the facility within 24 hours to assure the first bill is the most precise bill.
MARSI will help assure precision and consistency of:
- ICD-9-CM, CPT-4, E & M, APC and DRG Assignments
- clinical documentation
- medical necessity
- compliance with all federal and state statutes and regulations
- case mix index
- database integrity and quality
- subsequent reimbursement
While providing:
- ICD-9-CM, CPT-4 E & M, APC and DRG validation (undercode and overcode potential)
- complete APC & DRG education for coding staff and physicians
- assurance and recommendations for clinical documentation
- coding staff and physician confidence
- identification of utilization review and risk management issues
- sustainable results through successful education
- continuous quality assurance
The defensibility of all principal and secondary diagnoses and/or procedure codes, complications/comorbidities, final DRG assignment, and clinical documentation are validated to assure precision and consistency. Our focus is to provide sustainable results through successful education implemented throughout the facility regarding all aspects of coding and documentation.
MARSI's programs are designed to be a non-intrusive extension of the HIM Department. On-site education seminars are available if needed to help implement additional benefits or address special needs.
MARSI's programs allow continuation of the review and education process at the discretion of the facility. The program provides an ongoing compliance assessment for precision and consistency of coding and clinical documentation with no obligation to continue.
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