Medlinks Cost Containment, Inc

DRG validation is a type of program which is used by many reputed healthcare organizations to bring down risk, defend claims and guarantee the accuracy of coded items. It also plays an important role in proper coding practices. The basic purpose of DRG validation is to assure that all patient information reported and coded by a hospital on its claim matches the information contained in the beneficiary’s medical record along with the physician’s records. That is why the best DRG healthcare companies can help coders realize the broad coding classification of services and conditions for convenient comparison when looking into the payment categories.        Listed below are facts about DRG validation systems as to how they can relate to coding — An organization must have options regarding the implementation of DRG validation, so that you can choose from either an internal coding staff or hire an outside vendor. Since DRG validation procedures and guidelines alw

It is necessary for all health insurance payer to regularly monitor their coding, billing, and documentation process done by the health care providers. This is necessary to make sure that there is no cases of fraud and abuse within the health care payment system. The insurer would request all the medical records from the provider in order to carry out the auditing process. After which all the documentation would be compared on the claim forms that were previously submitted and paid Under the best medical post-payment audit process, the department can only approve the medical documents that are less than $1,000 and without any requirement of prepayment auditing by the Payment Services. The documents approved by the department are then audited for compliance with payment rules on a post-payment basis — however, payments amounting to $1,000 or more are needed to be pre-audited. Some of the reasons why payment services need medical post-payment auditing are explained here. 1. To