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DRG Window AuditorTM Software

Comply with the Medicare DRG 3-Day Window

CMS has finalized new “Overpayment Rules” that have given rise to “Reverse False Claim” liability. The False Claims Act now contains new “Overpayment Rules” that stipulate refunding of any overpayment should occur within 60 days.

What it is

MedCom’s DRG Window Auditor Software is designed to assist hospitals in complying with the 72-hour (or the “three-day-window”) rule. MedCom’s DRG Window Auditor Software imports each Medicare remittance advice and provides a daily report of any possible outpatient overpayments that are related to an inpatient claim and meet the three-day rule.

Why use it?

It will help you identify and address potential compliance issues with the 72-hour rule and your Medicare population. This has become increasingly important in light of the new Reverse False Claim liability that applies to hospitals.

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