Clinical registry data represents one of the most detailed and accurate records of a hospital procedure or event. Due to the extreme granularity and complexity of this dataset, it is extraordinarily difficult for coders to analyze and consume this information accurately without a process to audit the record and receive assistance from the clinical team. hbRecon facilitates that process by translating the clinical data into the level of specificity a coder would need, automatically flagging potential mismatches, and fostering cross-departmental communication between clinical and coding teams.
hbRecon maximizes accurate coding efforts through the integration of hospital financial, coding, and clinical registry information. Leveraging the integration of combined datasets, the hbRecon platform algorithmically analyzes and determines a recommended Diagnosis Related Group (DRG) code.
"In tennis, you don’t just compete against the other players, you also compete against yourself. The greatest players are the ones who find ways to improve each and every day.
Using our hbRecon tool will help your hospital system take its game to the next level by identifying missed coding opportunities, improving communication between departments, and ensuring that the billing and clinical documentation are always in alignment.”
- Nicholas Gawrit, MBA, President & CEO
Description: The patient enters the hospital as an outpatient. The IP authorization was not properly secured. The patient had a Cath Lab visit in which an Impella device was inserted for mechanical ventricular support with a variety of MCC conditions.
DRG Assignment as Found in Coding System: (302) ATHEROSCLEROSIS W MCC
Automated hbRecon Mismatch Findings: The patient should have moved to IP status, as the patient received an Impella for mechanical ventricular support.
Recommended & Predicted hbRecon DRG Assignment: (215) OTHER HEART ASSIST SYSTEM IMPLANT
Monetary Value of Recommended Change: Increased value of case, $77,316.60 versus $6,613.80 - a positive difference of $70,702.80.gitudinal reporting.
Description: Within the coding system, the patient is coded as 2 vessels, 2 devices, and 1 vessel 1 device.
DRG Assignment as Found in Coding System: (249) PERC CARDIOVASC PROC W NON-DRUG-ELUTING STENT W/O MCC.
Automated hbRecon Mismatch Findings: Patient should have been coded as 2 vessels 3 devices DES and 1 vessel 1 device DES.
Recommended & Predicted hbRecon DRG Assignment: (246) PERCUTANEOUS CARDIOVASCULAR PROCEDURES W DRUG-ELUTING STENT W MCC OR 4+ ARTERIES OR STENTS
Monetary Value of Recommended Change: Increased value of case, $19,874.00 versus $12,005.00 - a positive difference of $7,869.00.
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