Finding the right DRG Finding the Fair Code

Since 2001 $455 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

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 During Co-Vid19 Crisis

Hospitals are losing an estimated $50 billion a month now, according to the American Hospital Association. And 134,000 hospital employees were among the estimated 1.4 million health care workers who lost their jobs last month, data from the Bureau of Labor Statistics shows. Across the country, hospitals reported seeing between 40 and 70 percent fewer patients from late March through early May, many of them scheduled for profitable services like orthopedic surgery and radiological scans.

New York Times, May 15, 2020

Every hospital in the country is suffering from the recent Coronavirus pandemic. Those in hard hit-areas are enduring overflowing ICUs, PPE shortages, and ventilator rationing concerns. Those in more rural regions that are not yet hard hit are suffering even more: elective procedures have been cancelled due to anticipation of the virus’ arrival in their region, and patients are staying away from emergency services even when they are needed. Heart attacks and strokes are going untreated in the community.

What is FairCode doing to help our client partners? The answer is simple: whatever we can.

We are not holding our hospitals to previously contracted volumes.

If our contract calls for 13 hours of review a day, and hospital volumes no longer support this number, we are reverting to actual billed hours, not contracted hours. It is our pledge that in these hard times, we are not going to hold a hospital to the letter of a contract that was based on volumes that no longer exist.

We are holding invoices until hospitals are compensated.

With a 4:1 gross return on investment, hospitals are universally collecting enough in increased billings and collections to pay our fee four times over. Our billing and collection schedule is timed to permit our client hospitals to collect this extra money before paying us.

We are increasing hours for those hospitals that request it.

During hard times, the truth is that hospitals need us more than ever. The wisest among them actually are increasing the volume of their reviews (if admission volumes support this) and squeezing every last available penny out of those admissions they do have.

Our quality is unchanged.

Our return on investment for the 12-month period before the pandemic, across all clients: 3.97:1. For the period between mid-March and May 1st: 3.98:1.

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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

Udele J. Tagoe M.D.

Our Results

We have returned over $455 million to our clients in our 19 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

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

Arkansas Hospital Association
Tennessee Hospital Association
Kentucky Hospital Association
Virginia Hospital and Healthcare Association
Hospital and Health System Association of Pennsylvania