Product

Transfer DRG Underpayment Recovery

Our experts will find and recover underpayments for you—and we don’t get paid until Medicare reimburses you

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Transfer DRG recovery with almost no ongoing hospital resources

Did you know the average Transfer DRG underpayment is $3,200 but can run as high as $70,000 per account? Our experts can help capture those underpayments with our remarkably cost-effective end-to-end recovery solution that takes you from search to recovery in just a few steps.

Our proprietary software identifies exactly where qualifying post-acute care was not provided, then follows up with a strict documentation and validation process. Your hospital can then review and approve any discovered underpayments, while our expert Transfer DRG team does the claim and appeals legwork with Medicare. Underpaid accounts are monitored daily, until you recover the reimbursement.


STEP 1 – Software identifies underpayments: We review four years of Medicare inpatient accounts using proprietary software to identify where qualifying post-acute care was not provided.

STEP 2 – Validation and documentation: Once underpayments are identified, they undergo a strict documentation process to validate with Medicare and the post-acute provider that care was not delivered.

STEP 3 – Underpayment results review: Discovered underpayments are delivered to your hospital for review and approval.

STEP 4 – Claim correction and appeals: Our expert Transfer DRG team completes all the claim correction and appeal work with Medicare.

STEP 5 – Ongoing monitoring: We monitor all underpaid accounts on a daily basis until you receive the incremental reimbursement.

Product Highlights
  • Proprietary software isolates the 2–3% of Medicare discharges that are potentially underpaid

  • Finds underpayments on historical accounts going back four Medicare fiscal years, even when coming in behind other vendors

  • Dedicated Transfer DRG team handles all validation, claim correction and appeal work with Medicare

  • 100% contingency fee; we get paid only when you do

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