CHN DRG review personnel consists of physicians and certified medical coders.

The team ensures that hospital bills reflect the appropriate classification of the Medicare Severity Diagnosis Related Group, which is used to establish the correct reimbursement.

Details of the service include:

• Reviewing of patient's medical records to validate diagnosis and procedure codes
• Evaluation for coding or grouping errors, and inappropriate DRG up-coding
• Calculation of the DRG
• DRG Provider Reimbursement

CBO Services

• Eligibility Verification
• Authorization Check
• Charge capture and Coding
• Audits – retrospective review of medical records
• CBO Revenue Cycle Management – Billing, Claims Generation
• Collections – Account Receivable follow up, Cash Posting, Patient Follow up, Denial Management
• Reconciliations – analytics, HMO Cap Pools

Clinical Revenue Cycle Consulting

• Assessment and Redesign
• Charge Description Master (CDM) Review
• Charge Capture & Lost Charge Review
• Denials & Billing Edit Assistance
• Master Patient Index (MPI) Clean up