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Cost management is focused on DRG Validation or payment
integrity reviews on a retrospective basis. UB-92 coding data is compared
with the medical record to determine accuracy of coding. These reviews
are chosen based on selection criteria or payment integrity flags. The
comparison is accomplished by using Parallel Auditor T software designed by
HCMTI. Through this process, inaccurate coding and unnecessary care can
be detected and corrected. This program and associated process has been
proven to detect coding maximization as well as issues of unnecessary care.
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