DRG CLAIMS MANAGEMENT Employee Directory

Hospitals and Health CareNew Jersey, United States11-50 Employees

DRG Claims Management, based in Saddle River, New Jersey, provides pre-payment DRG claims review services tailored for Medicare Advantage, Medicaid Managed Care, and other commercial payers. The company emphasizes high accuracy in DRG assignment and payment decisions by reviewing medical records against regulatory guidelines and official conventions, aiming to identify coding errors and potential overpayments before payments are made. Its approach relies on an algorithm-based auditing process and specialized DRG expertise to recover value while preserving provider relationships and obtaining signed DRG revisions to reduce the need for formal appeals. The firm supports payers on a national level, with experience across all DRG methodologies and pricing schedules, and reports substantial potential savings in typical DRG payment environments.

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