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RASI’s technology and proprietary algorithms identify outlier claims resulting in a high error rate

CASE STUDY Posted by Recovery Audit Solutions, Inc (RASI) | August 2022

Case Description:

A patient admitted to a hospital is assigned a DRG that is tied to an average length of stay (ALOS). When the inpatient stay exceeds the ALOS the claim is vulnerable to a possible overpayment. RASI’s technology and proprietary algorithms identify outlier claims resulting in a high error rate.


SUMMARY

Patient was admitted to the hospital and during their stay, a procedure was performed. The procedure was delayed which caused additional charges for the delayed days. RASI’S proprietary algorithms and audit expertise resulted in a substantial reduction of the original payment for our client and the patient.


BENEFIT
  • $33,716.95 dollars recovered in 30 days

  • Improved internal processes

  • Increased future savings


FINAL RESULT
  • Original Payment Amount: $77,523.17

  • New Payment Amount: $43,806.22

  • Savings: $33,716.95

How Can RASI Help You?

Recovery Audit Solutions, Inc. (RASI) provides a broad range of payment integrity, data analytics, auditing, and compliance services for our clients.

RASI combines advanced technology and innovative processes with an experienced staff who have the knowledge and skillset to perform audit reviews on all services and claim types.


CONTACT
PHONE: 484-845-1373 Ext. 101
EMAIL: info@recoveryauditsolutions.com

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