Transfer reimbursement. Recovered when the record says it is due.
GRT identifies transfer and per-diem claims that may qualify for full DRG reimbursement, validates what actually happened after discharge, and supports rebilling through payment.
Recover full DRG reimbursement when transfer logic says it is due.
Automation identifies claims paid under transfer or per-diem methodologies that may qualify for full DRG reimbursement under Medicare rules or applicable payer contracts. Experienced analysts validate the finding, and GRT can rebill and track the claim through payment.
Automation finds per diem-paid claims that may qualify for full DRG reimbursement.
Experienced analysts confirm eligibility and reimbursement logic.
GRT can rebill validated claims with the payer.
Follow the claim through payment.
The discharge record captures the plan. The reimbursement decision depends on what actually happened next.
Per-diem payment must be identified
Not every transfer-coded claim is underpaid. GRT first determines whether the encounter was paid under the transfer or per-diem methodology and calculates the potential payment at the full DRG amount.
Planned care never occurred
The patient may have been discharged with an expected post-acute plan, but qualifying care may never actually have occurred after discharge.
Post-discharge activity lives elsewhere
Confirming what happened after discharge can require external Medicare and Medicare Advantage eligibility and claims data that is not part of the normal hospital billing workflow.
Home health may be unrelated
When home health begins or resumes after discharge, the plan of care may need to be obtained and clinically reviewed to determine whether the services were related to the hospitalization.
The claim is already closed
By the time the necessary post-discharge information is available, the hospital claim has often already been paid and moved out of the active revenue-cycle workflow.