Finding the right DRG Finding the Fair Code

Since 2001 $560 Million Recommendations
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 combines the domain expertise of experienced physicians with modern data science and analytics technologies. We bridge 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 and data scientists are a part of your team! Add us to your existing CDI initiatives, and see the difference.

Outcomes are measurable and significant. We average a greater than 4:1 Gross Return on Investment.

Click Here: What a Typical Client Has to Say About FairCode

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Fair Code CheckPredictive Data Analytics

FairCode has predictive software which provides a list of which charts require review and have the highest probability of documentation error. We are the happy marriage of human intelligence with the algorithms that constitute Artificial Intelligence.

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 competition has only 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.

FairCode Assists Hospitals With Quality Reviews

Hospitals not only need to survive during these times of crisis, they need to be able to document the quality of the care they render. FairCode has extensive experience performing quality reviews by multiple measures, most often for large academic medical centers, but also for community hospitals. Here are the quality metrics for which we have expertise:

Patient Safety Indicators

These 26 criteria include such events as iatrogenic pneumothorax, neonatal birth injury, post operative wound dehiscence and post operative pulmonary embolus. Each of these indicators in turn have exclusion criteria. FairCode has captured these exclusions and improved PSI reports.

Vizient Mortality Reviews

These reviews include APR DRG Risk of Mortality capture. FairCode has been performing APR reviews since 2003 and have found multiple positive predictors that improve mortality reports when run through the Vizient "black box".

Elixhauser Criteria

Counterintuitive, but critical for those facilities who are interested in their US News and World Report Rankings, FairCode has extensive experience performing these reviews for nationally recognized medical centers in the Northeast and the South, as well as systems built to capture and report these predictors.

Hospital Acquired Condition Reviews

Exclusions exist for Potentially Preventable Complications, and FairCode began reviewing for these at an Academic Health System in the mid-Atlantic more than a decade ago.

Present on Admission Reviews

There are 19 conditions for which a hospital can be "dinged" and assigned a lower DRG. FairCode can capture the documentation that these are often preexisting in a nursing home, or even in the ED.

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Working with FairCode has enhanced who I am as a person as well as who I am as a clinician. They are truly the most sincere, compassionate, cooperative and diligent people I have had the pleasure to work with.

Udele J. Tagoe M.D. Gynecology

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Udele J. Tagoe M.D.

Our Results

We have returned over $560 million to our clients in our 20 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

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Average number of cases reviewed per physician per hour

More than 2 Million

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Total number of cases reviewed

6 weeks

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Average time for to positive financial return.

4:1

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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. Click Here: What Our Physicians and Partner Hospitals Have to Say About Us Here are some of our partners who make it possible:

Kentucky Hospital Association
Virginia Hospital and Healthcare Association
Alabama Hospital Association
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