Ensure coding and documentation are optimized for reimbursement and compliance with Cloudmed’s award-winning Revenue Intelligence™ solution for DRG validation, powered by the CloudmedAI™ Platform.
Cloudmed DRG Validation is your safety net to maximize reimbursement, quality, and compliance. With the most experienced team in the industry backed by the powerful CloudmedAI Platform, Cloudmed helps you recover more revenue, faster.
Optimize your back-end revenue cycle with credentialed auditors reviewing 100% of inpatient cases. Cloudmed DRG Validation delivers a comprehensive review of patient demographics, clinical documentation, diagnosis coding, procedure details, charge entries, and physician billing, identifying DRG shifts and New Technology Add-On Payment (NTAP) opportunities that other solutions miss.
Cloudmed DRG Validation optimizes back-end revenue for health information management and patient financial services leaders.
Identify DRG opportunities faster with proprietary rules-based algorithms enabled by robotic process automation (RPA) and machine learning.
Recover every missed opportunity with help from the largest credentialed inpatient auditing team in the country.
Benefit from measurable process improvements in case mix index (CMI), accuracy, compliance, and quality.
Of inpatient cases reviewed
Discovery rate
Average findings agreement rate
More effective than manual audits
*Representative customer results
Partner with Cloudmed to tackle DRG complexities and help your team work smarter. Here’s a look at how we work together:
You provide high-level inpatient information using our universal data spec (UDS). Automated file extracts are delivered to your Cloudmed team weekly. Pre-bill or post-bill flexibility complements current clinical documentation improvement (CDI), computer assisted coding (CAC), or coding processes.
We validate the information and run it through our proprietary rules and machine learning algorithms. We review medical records and provide justification for all recommended DRG shifts and New Technology Add-On Payment (NTAP) opportunities.
Intuitive dashboards monitor and identify DRG shifts for staff to review, change, and bill in real-time. Our invoicing team monitors rebilling and resolution to maximize reimbursement.
Robust reporting and root cause analysis equip you to better manage your workflow, team, and ongoing education efforts. Leverage Cloudmed’s deep expertise across multiple payers and providers to implement changes quickly.
Capture missed or underpaid revenue for the care you provided, across the entire revenue cycle, with our comprehensive payment review that catches what others miss.
Ensure coding and documentation are optimized for reimbursement and compliance.
Identify inconsistencies in coding, charging, and billing to find missed reimbursement.
Improve revenue collection by identifying and recovering underpaid revenue.
Find out how Cloudmed DRG Validation Revenue Intelligence solution helps ensure coding and documentation are optimized for reimbursement and compliance.
