DRG Assurance

Thrive in Today’s Quality-focused Landscape

With reimbursements declining and denials increasing, how can organizations move toward pay-for-performance while continuing to succeed in fee-for-service arrangements?  A strong CDI program and proactive approach can help accelerate success toward value-based reimbursement. Designed to enhance financial and clinical accuracy, Enjoin’s Pre-bill DRG Assurance Program helps your organization thrive in today’s quality-focused landscape.

Take a deep dive into your current level of DRG accuracy to discover new revenue and education opportunities.

Proactive efforts yield revenue accuracy and risk mitigation

• Uncover missed documentation, coding and query opportunities
• Promote coding accuracy to drive revenue integrity and mitigate financial risk
• Reduce denials and associated costs for claims rework, audit and appeals

Using the pre-bill review process to review documentation and coding before claims submission, organizations ensure physician documentation supports coding compliance, DRG accuracy, and quality performance data.  Clinical Coding Analysts working directly with our board-certified physicians who are also credentialed documentation and coding specialists results in a powerful combination of clinical insight with coding know-how.

The power of the Enjoin pre-bill review

Daily pre-bill reviews of Medicare records and other payers continually drive coding and documentation compliance – yielding a 700% or more return on investment annually.

What makes the Enjoin pre-bill review unique?

• Physician-led team integrating evidence-based medicine with coding rules and guidelines
• Physicians with coding and documentation credentials and years of clinical expertise provide recommendations
• Daily educational feedback with coding and clinical references to support the recommendations
• Analytics and trending reports for targeted education, process change, and performance metrics
• Monthly customized DRG Focus List to target opportunity
• Educational resources to support knowledge transfer and CDI program advancement with goal of internalization

These reviews also help us develop a facility-specific CDI program to maximize clinical and coding accuracy. With Enjoin, you get a truly collaborative approach to CDI.