Our analysts are Transfer DRG specialists specifically trained to apply and interpret CMS guidelines specific to Transfer DRG claims to achieve the highest recovery results and to ensure accuracy and compliance. Adreima reviews all claims provided by the hospital, which have a qualifying discharge status code and a reduction in payment associated with the account. Once Adreima has a list of qualified accounts, we perform a triple-check verification process. Adreima checks with the Fiscal Intermediary or MAC responsible for the client’s service area to confirm the patient’s date of service; requests discharge summary information from the hospital; and contact the post-acute providers directly. The final step is a reconfirmation with the Fiscal Intermediary for those accounts that have been identified and based on our review, qualify for additional reimbursement.
Adreima’s analysts are specialists with expertise in applying and interpreting CMS guidelines specific to Transfer DRG claims to achieve the highest recovery results and to ensure accuracy and compliance
Armed with a qualified listing, Adreima commences with rebilling the eligible accounts. The verification forms document conversations, validate findings and are an important audit trail that becomes part of a patient’s permanent record. Should Adreima identify potential compliance issues, the client is notified and the account made available for further review.