DRG support and training

DRG SUPPORT AND TRAINING

Karol Consulting has extensive experience in the provision of services related to DRG system implementation including case coding practice, data analysis and audit. The firm has predominantly worked with the Australian AR-DRG system that has been adopted by all countries of the former Yugoslavia. Karol Consulting principals have worked on DRG implementation projects in Croatia, Macedonia, Montenegro, Bosnia and Herzegovina, Slovenia, Ukraine, and Turkey. Its Directors have participated and presented at patient classification international conferences in Avignon, Melbourne, Qatar, and The Hague. Karol Consulting offers the following DRG related services:

DRG coding services Inaccurate coding can be very costly for hospitals, and it is essential that appropriate DRG groups are assigned to cases so that hospitals are reimbursed their actual outlays. Coding advisory services provided by Karol Consulting have resulted in substantial financial benefits to their hospital clients. While specialist services can be designed to suit the particular needs of individual institutions, the two most popular are:

Advising hospitals on their DRG claims that have been rejected by the payer - In such situations, Karol Consulting will review DRG coding against medical documentation and identify discrepancies. Support is also provided in negotiations with payers so that fair payment is received by hospitals for the work undertaken.

DRG coding - The coding review service is available for all inpatient cases, or more selectively for complex and expensive cases where patients were treated for coexisting medical conditions, may have undergone expensive procedures, or their treatment required transfer between departments.

DRG Training Training courses in coding practice are designed according to specific needs, from beginner to advance levels. Courses are designed for both coders and auditors and at a general level they cover the following topics:

• Objectives of DRGs and their application
• DRG system design and logic
• AR-DRG documentation and its use
• Explanation of factors influencing health status and grouping
• Coding examples across the main DRG categories: circulatory, respiratory, digestive, musculoskeletal, genitourinary, neoplasms; blood disorders, endocrine disorders, eye and ear diseases, pregnancy, childbirth, perinatal and congenital conditions; injuries and poisonings.