Optimization Suite

Transfer DRG

Recover more revenue and achieve measurable gains in accuracy, compliance, and quality with Cloudmed’s award-winning Revenue Intelligence™ solution for transfer DRG, powered by the CloudmedAI™ Platform.

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The first and best transfer DRG solution

Cloudmed’s proprietary rules powered by the CloudmedAI Platform mine the Centers for Medicare and Medicaid Services (CMS) eligibility databases with pinpoint precision, exposing more revenue opportunities than our competitors can. Recover up to 70% more revenue.

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Transfer DRG Overview

Find and recover revenue lost through Cloudmed’s expert analysis of discharges against the transfer DRG ruling where the hospital should have received their full reimbursement versus a per diem payment. We bring the expertise you need with an elite team boasting decades of experience in post-acute care, Medicare and managed care billing, compliance, and regulation.

Cloudmed Transfer DRG is a back-end revenue optimization solution for patient financial services, revenue cycle, and health information leaders that recovers more revenue than competitive solutions.

Improve compliance and quality

Rely on comprehensive compliance checks and quality assurance performed by our multi-disciplined team with decades of experience.

Unburden your team

Allow us to do 100% of the work with a single pull of your data. You begin recovering revenue within 90 days.

Avoid overpayments

Avoid overpayments and audits with our comprehensive overpayment review. We can even handle your re-billing.

The Cloudmed Difference

Transfer DRG Results

98%

Average findings agreement rate

70%

More revenue recovered

90 days

To revenue recovery

*Representative customer results

Keep improving and maximize results

Realize measurable improvements in accuracy, compliance, and quality. There’s zero risk with Cloudmed’s 100% contingency fee-based model. Here’s how we work together:

Startup

You provide the data pull of all paid claims, grant Direct Data Entry (DDE) access for our research and electronic medical record (EMR) access to review medical records.

Review

We validate the data and run it through our proprietary rules and machine learning algorithms. Our expert team reviews the resulting worklists for additional recovery opportunities. Our initial review includes a four-year lookback.

Recovery

We prepare and verify the pre-bill list with the Medicare Administrative Contractor (MAC). We can perform the re-billing or follow-up weekly with your team to ensure re-billing is occurring. We monitor payments throughout the entire lifecycle within the Medicare system.

Continuous Improvement

Robust reporting and root cause analysis equip you to better manage your workflow, team, and ongoing education efforts. Plus, we provide custom education sessions from a former Chief Compliance Officer.

Ranked #1 by KLAS

We’re proud to be recognized for outstanding performance and excellence in customer satisfaction. In the Revenue Integrity / Underpayment Services segment, our clients rated us:

A+

Loyalty

A+

Operations

A

Services

A

Relationship

A+

Value
*Cloudmed is the 2021 Best in KLAS® in the Revenue Integrity/Underpayment Services and Robotic Process Automation (Databound) segments.
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Optimization Suite

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.

DRG Validation

Ensure coding and documentation are optimized for reimbursement and compliance.

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Charge Capture

Identify inconsistencies in coding, charging, and billing to find missed reimbursement.

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Underpayment Recovery

Improve revenue collection by identifying and recovering underpaid revenue.

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Transfer DRG

Find revenue lost through the Transfer DRG rule and recover underpayments.

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Find out how Cloudmed Transfer DRG Revenue Intelligence solution can help you recover more revenue and improve accuracy, compliance, and quality.