Identify Medicare over and underpayments and receive correct reimbursement on Transfer DRG claims.

More than 50% of Acute Care providers’ Medicare claims are impacted by the Transfer DRG Regulations. Since the beginning of this program, McBee has been supporting our clients around the country to ensure that they do not miss any revenue to which they are entitled by helping them identify underpayments. We recover reimbursement from transfer DRG underpayments that rightfully belong to your organization.

In addition, our overpayment reviews, where we validate Transfer DRG claims assigned a discharge to home status (01), will assist with confirming if your full DRG payments received were correct. Our fully compliant Transfer DRG Review verifies the correct reimbursement of Medicare claims that are subject to the Post-Acute Care Transfer Policy.

Our Transfer DRG Team has worked with hundreds of hospitals across the country, including some major health systems, and has over 20 years of experience identifying transfer DRG over and underpayments. McBee takes a holistic approach to address our client’s unique needs. Our process encompasses claims reprocessing and includes validation that can be used to update your billing files and support claim adjustments. McBee will submit corrected claims, verify acceptance of the corrected claim, and track the claim to final transfer DRG payments.

McBee has an awesome team of professionals who routinely recover all the revenue to which we are entitled. Their Transfer DRG support has been significantly impactful for our health system. They care a great deal about their clients, which is indicative of the level of compliance, follow-up detail and reporting consistently provided by the McBee Transfer DRG team.

Joni W. Perry, RHIA, Director Coding and Clinical Documentation Integrity - Health Information Management, UNC Health System

The McBee Advantage

Our approach to Transfer DRGs ensures our clients have complete control over which claims are adjusted and a total understanding of the reasons they are recommended for adjustment. Our consultants research each claim to identify the exact status of each discharge in the claim universe and ensure a fast turnaround. Our process is significantly more robust than simply comparing your data to the common working file.  We verify our findings with post-acute providers so there is never any doubt about our recommendations.  Your organization retains absolute and final control over which claims are adjusted and our fees are based upon recoveries. We recover the full DRG payments with minimal disruption to your staff, allowing you to keep business on track without daily operations being interrupted.  Over the years, our team has recovered approximately 15% more than either internal efforts, or those of other third parties.

  • Gain a dedicated team of McBee consultants and leadership

  • Engrain best practice into culture with staff education

  • Receive initial findings in 24 to 48 hours to ensure transfer DRGs are accurate

  • Fully Medicare-compliant approach

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WHITEPAPER

Medicare’s Transfer DRG Policy:
How Hospitals Uphold Compliance and Recommendations to Get Paid Correctly

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Discharge/Transferred to:

  • Home with Home Health or Hospice Care

  • Hospice Care at Inpatient Facility

  • Skilled Nursing

  • Rehabilitation Hospital or Rehabilitation Unit of Acute Care Hospital

  • Psychiatric Hospital or Psychiatric Unit of Acute Care Hospital

  • Long-Term Acute Care Hospital

  • Children’s Hospital

  • Cancer Hospital

410
Transfer DRG Clients

$96M+
Total amount of Transfer DRG recoveries

$3,400
Average Recovery per Claim

Contact us and receive a free estimate today for our Transfer DRG Review services.

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