DRG Validation: What Is It & Why Do I Care?
Recorded: December 1, 2016
CEUs: 1.0 – Clinical Data Management
Brief overview of DRG Validation auditing and what it comprises, why it is important to the overall HIM/healthcare industry, and some examples of DRG Validation audits.
Amy Morgan, MBA, RHIA, CCS is a health information management (HIM) professional that has worked in the industry for 20+ years. She has experience in many areas of HIM, including auditing/consulting, teaching & speaking (college level, professional association mtgs), authorship (HIM textbooks, journal articles), management, and revenue optimization. Among her various skill sets includes senior level total data quality auditing on a wide spectrum of facility coders, quality assurance (QA) audits on both complex ICD-10-CM and PCS auditors, as well as DRG Validation auditing that requires complex medical inpatient audit reviews for both MS-DRG and AP/APR-DRG’s for various payers, to include commercial insurance plans, as well as Medicare/Medicaid audits.
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