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Description

It is accurate to assert that "not all DRG vendors are equal." Although their marketing strategies may be similar, these vendors generally fall into two categories: those that cater primarily to provider hospitals and those focused on detecting overpayments for health plans and payers. Much like how attorneys often concentrate on either defense or plaintiff cases, auditing vendors tend to specialize in the distinct needs, cultures, and priorities of their respective clients. Within the realm of payer-focused vendors, a diverse array of strategies for DRG auditing and overpayment detection exists. Our service offerings also include a dedicated physician review team that generates clinical validation findings, specifically addressing cases where identified issues stem from unsubstantiated clinical diagnoses made by treating physicians, which goes beyond the capabilities of coders. Our findings consistently demonstrate that our coding compliance model yields verified savings, contributing to enhanced financial efficiency for healthcare providers. Thus, selecting the right vendor can significantly impact the financial health of both hospitals and payers alike.

Description

LexisNexis® MarketView™ provides medical claims-based insights tailored for healthcare payers, providers, life sciences enterprises, and health IT organizations throughout the United States. This platform offers actionable intelligence designed to enhance competitiveness, enabling businesses to uncover valuable insights and visualize transformative strategies. Regardless of whether you represent a life sciences firm, a health insurance plan, a healthcare system, or a health IT service provider, MarketView can significantly enhance critical business processes such as marketing, sales, strategic planning, physician engagement, outreach, market research, network optimization, talent acquisition, pricing strategies, contracting, and clinical management, among others. To stay ahead in the competitive landscape, your organization requires the most relevant insights available. However, determining the right areas to focus on can be challenging when the overall picture lacks clarity. MarketView addresses this issue by providing insights into various aspects such as referral trends, strategies for aligning with physicians, the performance of clinically integrated networks, and patient volume metrics, ultimately empowering organizations to make informed decisions. By leveraging these insights, businesses can drive innovation and improve their operational effectiveness.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

No details available.

Integrations

No details available.

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Pricing Details

No price information available.
Free Trial No 
Free Version No 

Deployment

Web-Based Yes 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Deployment

Web-Based No 
On-Premises No 
iPhone App No 
iPad App No 
Android App No 
Windows No 
Mac No 
Linux No 
Chromebook No 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Customer Support

Business Hours Yes 
Live Rep (24/7) No 
Online Support Yes 

Types of Training

Training Docs Yes 
Webinars No 
Live Training (Online) No 
In Person Yes 

Types of Training

Training Docs Yes 
Webinars Yes 
Live Training (Online) No 
In Person Yes 

Vendor Details

Company Name

DRG Claims Management

Founded

2009

Country

United States

Website

www.drgclaims.com/solutions/

Vendor Details

Company Name

LexisNexis

Founded

1970

Country

United States

Website

risk.lexisnexis.com/products/marketview

Product Features

Product Features

Insurance Claims Management

CRM No 
Claims tracking No 
Customer portal No 
Document management No 
EDI data exchange integrations No 
Electronic claims No 
Fraud management No 
Reporting No 

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