How hospital medical record departments can benefit from retrospective DRG review

DRGs and PPS have had a major, negative effect upon hospital reimbursement. Hospitals now focus upon methods for improving and increasing reimbursement from third-party payers. More payers are using DRG-based reimbursement methods. DRG payment review offers a viable solution to the problems brought by stringent payment plans and has potential benefits for the MRD as well. MRD directors should investigate DRG payment review alternatives and from such efforts, attempt to maximize the benefits to the hospital and their own departments. Success with DRG payment review identifies the MRD as an objective, results-oriented revenue generator and, thereby, can improve performance throughout the hospital and among the medical staff.