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Average Ratings 0 Ratings

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ease
features
design
support

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Description

It is accurate to assert that "not all DRG vendors are equal." Although their marketing strategies may be similar, these vendors generally fall into two categories: those that cater primarily to provider hospitals and those focused on detecting overpayments for health plans and payers. Much like how attorneys often concentrate on either defense or plaintiff cases, auditing vendors tend to specialize in the distinct needs, cultures, and priorities of their respective clients. Within the realm of payer-focused vendors, a diverse array of strategies for DRG auditing and overpayment detection exists. Our service offerings also include a dedicated physician review team that generates clinical validation findings, specifically addressing cases where identified issues stem from unsubstantiated clinical diagnoses made by treating physicians, which goes beyond the capabilities of coders. Our findings consistently demonstrate that our coding compliance model yields verified savings, contributing to enhanced financial efficiency for healthcare providers. Thus, selecting the right vendor can significantly impact the financial health of both hospitals and payers alike.

Description

Aptarro's HCC Coding Engine is a cutting-edge AI solution that works in harmony with electronic medical records and practice management systems, enabling real-time scanning of every patient interaction to automatically identify and rectify coding discrepancies, ensuring that all Hierarchical Condition Category (HCC) diagnoses are correctly recorded for effective risk adjustment and revenue optimization. Utilizing established industry rules and advanced machine learning algorithms, the engine highlights high-priority encounters for coder assessment, significantly enhancing coder productivity by as much as 300% without increasing the workload for providers, while simultaneously minimizing denials through instant validation and compliance enhancements. The system features exception-based workflows, user-friendly dashboards that track RAF score trends, integrated audit trails, and logging capabilities, and offers rapid deployment within current processes, allowing organizations to experience immediate returns on investment during their initial billing cycle and recover millions in overlooked revenue, all while upholding clinical focus and ensuring the integrity of documentation. This innovative approach not only streamlines the coding process but also empowers healthcare organizations to maximize their financial performance without compromising patient care.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

DRG Claims Management

Founded

2009

Country

United States

Website

www.drgclaims.com/solutions/

Vendor Details

Company Name

Aptarro

Country

United States

Website

www.aptarro.com/hcc-coding

Product Features

Product Features

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