Reimbursement is the lifeblood of hospital and health center operations. We partner with our clients to allow additional resources to shift focus from denial management to denial prevention. Our unique expertise helps our clients recover lost funds and limit denials to maximize revenue stream. The unique ability of Adreima to inject critical thinking into all stages of the coding and reimbursement process offers a clear advantage. Our industry expertise, gained from working with more than 600 hospitals nationwide, means we understand payer behavior and can speak with authority.
Our physicians and clinicians lead the denial management effort with compelling reasoning, while our clinical documentation experts minimize the day-to-day burden on your clinicians – so their focus remains on delivery of care. The benefits include:
Our concurrent medical necessity and retrospective reviews save valuable time for hospital case managers.
Designed to supplement your clinical efforts, this service provides concurrent, evidence-based recommendations for documentation surrounding length of stay and patient status.
Our specialists are trained to apply and interpret CMS guidelines specific to Transfer DRG claims including a triple-check verification process.
We help information management systems and patient accounting team members to determine if payments are correct and review paid claims to determine if additional recovery is possible.
With a full complement of technical, legal and clinical expertise, Adreima handles denied claims, concurrently and/or retrospectively.
Our HIM and clinical professionals identify and correct coding inaccuracies resulting from system, procedural or compliance challenges.