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TechValidate Research on Besler

1 Case Study


Besler Case Study

Large Health System

Introduction

This case study of a large enterprise health care company is based on a June 2017 survey of Besler customers by TechValidate, a 3rd-party research service. The profiled company asked to have their name blinded to protect their confidentiality.

“Besler met or exceeded my projected revenue recovery.”

“Besler recovered Transfer DRG revenue for my hospital that otherwise would have been lost.”

“My organization was able to quickly realize new revenue from working with Besler.”

“My organization plans to continue working with Besler on Transfer DRG revenue recovery going forward.”

Challenges

The business challenges that led the profiled company to evaluate and ultimately select Besler:

  • Faced the following challenges prior to working with Besler on Transfer DRG revenue recovery:
    • Wanting to confirm that no underpayments went undetected after internal review
    • Limited staff time to review and adjust claims
    • Ensuring transfer underpayments are recovered in full compliance with Medicare regulations

Use Case

The key features and functionalities of Besler that the surveyed company uses:

  • The organization does not have a primary Transfer DRG revenue recovery vendor before working with Besler.
  • Listed the following as the most important aspect of Besler’s Transfer DRG service:
    • A multi-faceted validation process that included telephone validation with post-acute providers and the review of clinical documentation from the hospital medical record
    • Thorough review of all affected claims until final determinations were made
    • Clinical review of certain scenarios to ensure clinical compliance before an underpayment determination was made
    • A turnkey experience including Besler’s review, determination, and claim adjustment of verified underpayments

Results

The surveyed company achieved the following results with Besler:

  • Saw the following benefits from using Besler’s Transfer DRG revenue recovery service:
    • An increase in revenue that would not have been found using existing processes
    • Quick recovery of identified underpayments
    • Confidence that all underpayments were recovered in compliance with Medicare regulations
    • Process improvement recommendations



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