Stop leaving revenue on the table with inaccurate DRGs
Our DRG optimization specialists analyze your case mix to ensure every diagnosis is captured, every procedure is coded correctly, and every dollar you've earned is reimbursed.
Accurate DRG assignments drive accurate reimbursement
Reduce Underpayment
Identify cases where secondary diagnoses, complications, or comorbidities weren't captured, leading to lower-weight DRG assignments and reduced payment.
Accurate Reimbursement
Ensure every case reflects true clinical complexity. Our coders cross-reference documentation against DRG logic to capture the most accurate assignment.
Concurrent & Retrospective Review
Catch DRG issues before claims go out the door with concurrent reviews, or recover lost revenue with retrospective optimization audits.
Case Mix Index Improvement
Improve your facility's CMI by ensuring clinical acuity is accurately reflected, supporting better resource allocation and payer negotiations.
From missed revenue to optimized DRG in four steps
Submit for Review
Upload cases with the assigned DRG and expected DRG through our secure portal. Include clinical documentation for our team to review.
Expert Analysis
Our certified coding specialists review the clinical record against MS-DRG and APR-DRG grouper logic to identify optimization opportunities.
Recommendations & Queries
Receive detailed findings with recommended DRG changes, physician queries for missing documentation, and revenue impact analysis.
Track Impact
Monitor recovered revenue and CMI improvement in real-time through your ClaimGuard portal dashboard.
Every undercoded DRG is revenue your facility earned but never received
Our DRG optimization team has recovered millions in underpayments. Let us review your cases and show you exactly how much you're leaving on the table.