MS-DRG Coding Quality Audit Overview

OptumInsight consulting team provides deep expertise

OptumInsight consultants combine decades of coding experience and executive-level management of health information, compliance, and patient financial services to help your hospital build an effective and compliant coding practice. Our consulting services will incorporate a detailed analysis of your historical coding data to help you reduce unnecessary risk.

Improve documentation and coding practices

• Reduce legal and financial liabilities
• Validate current reimbursement
• Increase security in health information management

Unique methodology delivers optimal results

Whether you need a single review or quarterly compliance audits, we will tailor our approach to your business needs. We strive to help hospitals increase compliance, validate reimbursement, increase security and confidence in HIM operations, and provide independent analysis of coding and documentation practices.

Comprehensive program offers support in every phase of the process

OptumInsight will work with your hospital to define a sampling plan that meets the audit’s objectives. We review randomly selected records and then look for variances that translate into significant trends. Next, we conduct an exit conference and coder education session. Finally, we submit an individualized written report with recommendations for improving coding quality.