Transfer DRG

Transfer DRG is eSolutions’ proprietary technology that allows us to conduct underpayment audits on your facility’s behalf and ensure you’ll receive reimbursement for Transfer DRG claims.

Medicare underpayments can occur when a patient is discharged as a “transfer,” but there is no post acute-care billing. This often happens when a patient decides to forego the recommended post-acute discharge. When a patient decides not to transfer to a post-acute facility in accordance with CMS rules, the discharging hospital is entitled to the full DRG payment but only receives partial payment. When this happens, it’s up to your hospital to recuperate the full payment it’s due.

Transfer DRG allows us to conduct underpayment audits for your organization to ensure you are reimbursed for those claims. Our automated processes require only a minimal data set to identify eligible claims, resulting in a fast turnaround.

Every Claim Examined

Automated search of 100% of variances with minimal data set (15 fields)

Retrospective Filing

Audit and correction of discharge status codes for the previous four years

Due Diligence

Direct contact with FI/MAC, SNF, HHA to validate accuracy of corrections

What makes eSolutions’ Transfer DRG different?

  • Unique relationships with MACs
  • Intelligence built into our solution
  • Actual recovery in as little as 14 days
  • Verifiably non-disruptive
  • Medicare Advantage also reviewed
  • Comprehensive condition code review
Transfer DRG With eSolutions' Medicare Enterprise Standalone
Compliant with HIPAA
Compliant with PACT rules
Claim correction included
No medical record pulls
No additional Medicare enrollments
No data extracts required
Seamlessly integrated
Fully automated
Time to reimbursement 2 weeks 4-6 weeks

$100+ MILLION recovered for healthcare providers

average recovery per underpaid claim

Request more information on Transfer DRG


Want to see this solution in action?