Meridian's DRG Validation program ensures that hospital bills reflect the appropriate DRG code, which is used to establish the correct reimbursement. The process consists of an in-depth review of the patient's medical records to validate the diagnosis and procedures that were used to establish the DRG for the claim being billed. Meridian then uses state of the art software to determine DRG abuse, utilizing specific edits to identify inaccurate coding, re-sequencing and "DRG creep."

Meridian has created a valuable database, which supports clients across the country with accurate coding and DRG grouping information. Each time a claim is screened, reviewed, or changed, it is entered into our database and the profile for the hospital is automatically updated. This data enables us to monitor many hospitals' coding patterns and focus on DRGs that have historically been a problem

The Meridian DRG review personnel are all experienced coding professionals with formal ICD-9-CM and DRG coding training. The majority of the staff of Registered Health Information Administrators (RHIA) are also Certified Coding Specialists (CCS). Each coding staff member has a minimum of five years of hospital Medicare coding experience.

  See actual examples of recoveries from Meridian's DRG Validation Program.

For additional information on DRG Validation Services, click on the "CONTACTS" button at the top of this page.