MS-DRG Integrity
The gold standard — and the biggest blind spot.
We’re rebuilding inpatient strategy one DRG at a time.
PDGM (Home Health)
30-day windows, 432 buckets, shrinking margins.
Let’s navigate PDGM without the guesswork.
Hospice
When hospice starts, MA responsibility ends — or should.
We make sure the data matches the status.
Readmissions
If the patient comes back, it’s not just a visit — it’s a signal.
We decode the pattern.
ED Leveling
When everything feels urgent, billing should still feel clear. MDM is the rule - are we following it?
APCs ~Outpatient
Outpatient isn’t low-risk — it’s under-reviewed.
Time to close the gaps.
ESRD & Capitation
1% of members, 7% of spend.
Claims, coordination, and a capitation strategy that actually catches the risk.
Short Stays
Two midnights is the rule. But clinical judgment?
That’s where the real review begins.
PDPM (SNF)
RUGs are out, complexity is in.
Here\'s how we keep SNF claims honest under PDPM.
DME
Durable Medical Equipment that lacks durable documentation. We’re on it.
Outlier Payments
When DRG meets astronomical charges — we follow the math behind the margin.
NICU
High acuity in tiny bodies. We don’t just audit neonatal claims — we read between the lines.