Have you received your RAC Demand Letters? Are you performing internal audits, and looking for validation?  Our MS-DRG Validation service will give you confidence in your MS-DRG Assignment and appropriateness of Medical Necessity.

RACauditor has partnered with MedLearn, the nation’s most respected authority on medical coding, compliance, and reimbursement. Since 1991, MedLearn’s team of experts, with clinical experience -- qualified, seasoned, professionals – have remained a trusted source for hospitals and physician practices throughout the country.

We will look at your cases (pre-bill or post-bill) and validate the MS-DRG assignment with a MedLearn Credentialed Coding Consultant (for coding), and a Credentialed Case Manager (for medical necessity). We can do it remotely, quickly, and accurately (within 72 hours of receipt upon request).

All official coding guidelines and admission screening criteria will be cited for all recommendations with payment impact. If your records have been requested by the RAC, rationale for why we agree, or disagree, with your coding assignment and/or validation for appropriateness of the inpatient admission for a one day LOS, short stay, or 3 day SNF transfer cases, will be provided. This may be used for the discussion period to justify your MS-DRG assignment and codes, and medical necessity billed.

KEY BENEFITS

• Expedite Response to RAC Demand Letters
  
  
• Justify Your MS-DRG assignment,
  and codes and medical necessity billed
  
  
• Cases reviewed remotely, quickly
  and accurately within 72-hours upon request
  
  
• Receive credentialed expert's recommended course of action
  
  
• Recommendations include payment impact
  
  
• Only $190 per record for both coding
  and medical necessity... no minimums

We will provide a comprehensive assessment that supports the recommendation, or outlines recommendations for improvement.

We Use Sources Such as:

• ICD-9-CM Code book (applicable year)
  
  
• ICD-9-CM Official Guidelines for Coding and Reporting
  
  
• AHA Coding Clinic
  
  
• AHIMA Practice Brief : Managing an Effective
  Query Process Patient status (discharge disposition)
  
  
• Recovery Audit Contractor Region policy
  as posted on their website