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What do we mean by "Finding a Needle in a Haystack?"
Transfer DRG Underpayment Variances
Since 2005, MCare has found on average:
- 60% of hospital medicare inpatient discharges have a Transfer DRG;
- 33% of the total Transfer DRGs have a length of stay less than the geometric length of stay (representing potential underpayments); and
- 10-15% of the total Transfer DRGs have a coding error that actually results in recovered underpayments.
- 1-3% of the total Transfer DRGs have actual coding variances for which MCare can rebill the claim and for which the hospital will obtain the additional reimbursement.
