Finding the right DRG Finding the Fair Code

Fair Code: 380 million recommnedations accepted

FairCode physicians uncover hidden truths in inpatient documentation, and partner with hospital CDIs and coders to assign the most accurate DRG.

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What We Do

FairCode bridges the gap between your attending physicians and hospital coders. The result? Patient acuity and Case Mix Index is more accurately captured; your reimbursement adjusts accordingly. Physician-conducted medical chart reviews happen in real time, significantly impacting quality and bottom line results. From clinical chart reviews to payor denial defense, our physicians are a part of your team! Add us to your existing CDI initiatives, and see the difference.

Fair Code CheckPhysician Chart Reviews - DRG Validation

Unlike our competition, at FairCode, physician chart review means just that. 100% of your selected charts are physician-reviewed. And not just any physician: FairCode physicians undergo extensive training in the principles of inpatient coding, and excel at improving the specificity and accuracy of documentation. The other guys have nurse/coder review, with occasional physician input. Every chart is reviewed by a FairCode physician, a hospital coder, and, where necessary, the patient's attending physician, before the DRG is changed.

Fair Code CheckDenials Appeals

Let's face it: denials happen. But a FairCode-reviewed chart is 13 times less likely to be denied by the payor. And, when appealed, is twice as likely to have the denial overturned. But whatever the source of your coding or UM denials, FairCode can help. Our dedicated appeals team of physicians has years of experience reasoning with recalcitrant payors -- and winning.

Fair Code CheckPopulation Health Management

By improving the clinical accuracy on inpatient claims, hospitals are better able to accurately report risk of mortality/expected versus actual mortality rates. Quality indicators and risk factors are captured and reported.

Physician Conducted Reviews

Your coder knows more about coding than any doctor. Our doctors know more about clinical medicine than any coder or CDI. Together, they form a formidable firewall against errors and omissions, and in support of the correct clinical indicators for the DRG assignment.

Often coders are handcuffed. Attending physicians document for each other, not to satisfy coding requirements. Worse, they don't answer coder queries. Here's where FairCode physicians serve as allies: Your hospital is assigned a team of physicians who review your charts before the bill is dropped. (No anonymous "doc of the day" here. Your coders and our doctors actually get to know each other.) They recognize the clinical indicators, and educate the coding staff on the nuances of complicated cases. They write peer-to-peer physician queries and get a response 97% of the time. The team is there to support your hospital coder -- who always has the final say in DRG assignment.


Peer to Peer Physician Queries

Increase documentation accuracy and specificity. 97% average response rate across all hospitals.

Evidence-based Pull Lists

Select which DRGs to review. Predictive pull lists and algorithms garnered from more two decades of reviews let you optimize your consulting budget.

Built to Scale

Start small or start big. Our staffing and technology is entirely scalable to your needs.

Turn Key Launch

No software installations. No batch updates. No onerous IT interfaces. All data is HIPAA secure on the cloud. We work with all EHRs currently on the market.

Compliance

No leading queries. HIPAA secure data. Decreased risk of incorrect coding. Add us to your compliance program.

Data Collection and Reporting

Our robust proprietary software products provide real-time reporting of every applicable metric, sliced and diced by any date range, format or filter. Accessible anytime, anywhere. No customization required.

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Our doctors not only heal patients; they heal health care systems. I'm proud of everyone in the company.

Tracey Goessel, M.D. FairCode Co-Founder

Tracey Goessel, M.D.

Our Results

We have returned over $380 million to our clients in our 17 years' experience.

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I love working with Fair Code. I have a very good working relationship with their team. They are very customer friendly and receptive to the needs of the client. They have a good understanding of revenue cycle and changes from an HIM Director perspective.

Susan Denny Jupiter Medical Center, Director of HIM

3.8

Fair Code Dots

Average number of cases reviewed per physician per hour

1.3 Million

Fair Code Dots

Total number of cases reviewed

6 weeks

Fair Code Dots

Average time for to positive financial return.

4:1

Fair Code Dots

Average gross ROI for all clients

Get Your Free DRG Assessment

We will provide you a free, custom analysis, detailing the potential value of physician reviews at your facility.

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Fair Code Partnerships

We work with clients from across the country. Here are some of our partners who make it possible:

Arkansas Hospital Association
Tennessee Hospital Association
Kentucky Hospital Association
Virginia Hospital and Healthcare Association