Accuracy rates for all elements including:
- MS-DRG (Medicare Severity Diagnosis Related Groups)
- APR-DRG (All Patients Refined Diagnosis Related Groups - Copyright 3M)
- SOI (Severity of Illness - Copyright 3M)
- ROM (Risk of Mortality - Copyright 3M)
- Diagnosis (ICD-10-CM or ICD-9-CM)
- Principal Diagnosis
- Secondary Diagnosis
- POA (Present on Admission)
- Discharge Disposition
- Procedure (ICD-10-PCS)
- CPT/HCPCS (Current Procedural Terminology/Healthcare Common Procedural Coding System - optional)
- Procedure Provider
- Procedure Date
- MCC (Major Comorbidity or Complication)
- CC (Comorbidity or Complication)
- CMS-HCC (Heirarchical Condition Category)
- HAC (Hospital Acquired Condition)
- Customizable Overall Accuracy Rate
Both MS-DRG and APR-DRG grouping and pricing take place within the software eliminating the need for auditor to “toggle” between an encoder and ReviewMate. This also eliminates the need for auditors to re-enter codes and demographics into an encoder/grouper to make resequencing decisions.
Full suite of references including Coding Clinic, CPT Assistant, Coding Clinic for HCPCS, Clinotes, Principal Diagnosis Analysis, DRG Analysis, AHA Coding Handbook, and code look-up eliminating the need for auditors to access an outside product to perform research
Identification on the screen of codes with MCC/CC/HAC and CMS-HCC values.
Full suite of edits/warnings including gender and age conflicts, MCE edits, critical error and TruCode warnings.
Reconciliation of rebuttals occurs inside of ReviewMate.
Conversations between the auditor and coder are saved in a chronological manner and can be accessed by any user.
Accuracy rates available real-time and can be sliced and diced to accommodate different situations and date patterns.
Extensive library of customizable and exportable reports from raw data to Executive Summaries.
Customizable dashboards to enhance the user experience.
Multiple user levels allow view-only access to any interested parties providing transparency within your organization.
“Audit the Auditor” available for a higher-level quality check of any audit in ReviewMate.
Support for Profee audit within the IPPS module.