Health Information Management
DRG Validation Services
Jzanus Consulting ensures the accuracy of codes and DRG assignments that are submitted to third party payers in order to maintain compliance with federal and state guidelines for coding and billing purposes. Assist hospitals with obtaining the highest appropriate recognition for the care and severity of illness to which it is entitled. Jzanus Consulting’ proven approach is designed to capture all instances where improved coding affects DRG assignment and severity scores.
Our HIM professionals providing coding reviews are all (RHIA, RHIT or CCS) and average nineteen years of coding experience. These highly experienced individuals have expertise in both the compliance and the financial ramifications of coding and work extensively with APR DRG’s across our large customer base. The consultants have a deep-rooted knowledge of coding, clinical disease processes, DRG grouping methodology and physician documentation requirements assuring our customers of an accurate and reliable audit.
Validation reviews can be conducted either onsite or on a remote basis on a prebilling or post billing basis. We can provide 24-hour turnaround of all referred records seven days a week.
Ask about our Complimentary DRG Coding Assessment that focuses on coding accuracy and clinical documentation effectiveness.
Benefits of Jzanus Consulting Services:
An independent third-party review process to ensure accurate coding, appropriate reimbursement, and mitigate risk.
Clinical documentation review for professional fees, patient acuity and severity levels.
Necessary documentation for appeal preparation.
A mechanism for identifying insufficient or inconclusive documentation for actual changes in the
Case Mix Index.
Best practice education for coders and providers based on results of assessment review
Comprehensive reviews to ensure that all appropriate codes are captured to ensure the highest quality and SOI measurements are achieved.