Overview
Traditional DRG validation programs provide a valuable service: identifying costly inpatient billing errors. But their focus on post payment review can lead to challenges in recovering funds from an overpayment, sometimes leading to provider dissatisfaction and member discontent. In Cotiviti鈥檚 experience, recovering erroneous payments can take over 90 days, and recovery can yield a mere 70% of the incorrect payment.
Cotiviti recognizes the pressing need for a solution that not only addresses these challenges, but also unlocks hidden value within the DRG validation process. Enter our prospective Clinical Chart Validation (CCV) solution鈥攁 game-changing innovation designed to complement retrospective paid claims approaches, increase recovery rates, elevate medical record receipt rates, and reduce administrative costs by as much as 15%.