The Impact of DRG Audits on Provider Sentiment and Abrasion
To better understand how payment integrity initiatives, impact the payer-provider relationship, Change Healthcare commissioned Frost & Sullivan to conduct a national research study. Our study is the first of its kind to explore provider opinion about traditional tactics, such as Diagnosis-Related Group (DRG) audits and post-pay review, as well as non-traditional tactics, such as pre-submission review.
The results shed new light on the primary factors contributing to provider abrasion, including the high volume of medical requests, prevalence of technical denials, and high administrative costs of audit compliance. The study also uncovers a strong provider preference for pre-submission notification over post-pay DRG audits.