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DRG Anomaly Detection

The simpler way to increase efficiency + revenue

With payers routinely adjusting policies and guidelines, ensuring DRG accuracy can drain resources and impede productivity. Because DRG assignments often require interpretation, it takes time to systematically review accounts.

Waystar makes that process precise and painless. Our DRG Anomaly Detection solution combines advanced tech, a huge data set, and expert auditors to take the burden off your team. We provide a consistent, systematic coding approach to recover missing revenue and increase collections.
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Comprehensive + accurate analysis

DRG Anomaly Detection helps you overcome your biggest DRG challenges, from recouping missed revenue to reducing compliance risk, addressing staffing costs, and strengthening QA. Powered by machine-learning algorithms, the Waystar platform continually evaluates thousands of accounts every day, constantly adjusting to valid changes in coding behavior to ensure 100% of accounts are assessed for assignment errors.

With comprehensive reporting on errors by areas such as Major Diagnostic Category, service line, or medical versus surgical (and more), you can easily pinpoint root cause issues and open up additional revenue opportunities by evaluating accounts based on predicted versus actual DRG.

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The best of AI + an expert auditing team

Waystar leverages AI to automatically audit claims, build out detailed reports on the process, and generate high-accuracy DRG assessments. DRG Anomaly Detection also gives you increased visibility into coding opportunities, case data, and areas to target for improvement.

With Waystar’s DRG Anomaly Detection, your team can easily:

  • Track and trend revenue loss with customizable reporting, dashboards, and proactive alerts
  • Increase productivity and focus on actionable accounts that drive net revenue
  • Record detailed notes, reducing time spent reviewing performance down the line
  • Pre-bill and/or post-bill configuration options and customize assessments

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Solutions that augment DRG Anomaly Detection

Our solutions work together seamlessly to help bring even more value to your organization. Realize even greater benefits by exploring solutions that enhance DRG Anomaly Detection below.

Complementary SOLUTIONS

Charge Integrity  |  Transfer DRG

Talk with an Anomaly Detection expert

We’re always available to chat more about your organization’s challenges and needs. Want to learn more about DRG Anomaly Detection? Fill out the form below and one of our experts will be in touch shortly.