Case Study
How DHR Health Used MDaudit to Scale Monthly Audit Volume by up to 900% and Reach 99.9% Coding Accuracy
Even as its Corporate Compliance Team grew from two to seven people, DHR Health’s manual coding and DRG validation audits kept volume low on both the hospital and professional sides. The team needed to go electronic, and needed the data to bring physician-owned leadership along with them.
Background Summary
Physician-owned health system goes electronic and scales monthly retrospective audits by 900%.
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See how DHR Health used MDaudit to scale monthly audit volume by up to 900% and reach 99.9% coding accuracy.
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The Customer Profile
DHR Health is located in Edinburg, Texas. It is a rapidly growing, for-profit, physician-owned health system with multiple locations across Texas’s southern border, and is nationally recognized as a best-practice model minority-serving hospital.
The Solution
MDaudit’s billing and compliance platform automated DHR Health’s retrospective and prospective auditing, replacing manual processes on both the hospital and professional sides and giving the compliance team the data it needed to win leadership buy-in and support provider education.
- Real-time regulatory updates meant analysts no longer had to research the latest guidelines themselves, so auditors always had current rules in hand
- Benchmark data let leadership compare DHR Health and its providers nationally against peers in the same specialty, building the case up through the VP of Compliance to the Board
- Reframing provider education as resource and guidance, paired with tailored reporting, made providers more receptive and drove accuracy gains
The Results
- Increased monthly retrospective audits by 900% and prospective audits by 200%
- Expanded HB DRG audits from 100 to 800 encounters per month, with a special focus on high-dollar accounts
- Improved provider coding accuracy by 22%, reaching 99.9% coding accuracy overall
- Grew the share of physicians hitting the 95% accuracy target from 78% to nearly 100%
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