DRG
DRG Grouper for Insurance Companies
DRG Grouper classifies hospital cases into nearly 1,200 cost and medical-like groups. They classify patients not only from the medical point of view but also according to the financial demands of their treatment. With this classification, health insurers can pay hospital care more equitably, while at the same time increasing the efficiency of spending money in the healthcare system.
Key Functionality
Basic module Strix
| | Classification into one of almost 1200 DRG groups |
| | The payment for each type of hospitalisation (DRG group) is based on actual costs from previous period |
Analytic module
| | Structural review of production, errors and impacts of DRG |
| | Comparison of hospitals in Slovakia also in specific groups |
| | Detailed overview of each provider |
| | Feedback for providers |
Revision module
| | Quality check for reporting and adhering to the rules of coding |
| | Conflict notifications among received information |
| | Identification of extraordinary cases |
| | Identification of high proportion of cost cases from provider |
Key Benefits
Basic module Strix
| | The payment amount for each patient is closely considered according to the severity of the treatment |
Analytic module
| | Quick overview and comparison of hospitals |
| | Calculation of the base rate |
| | Materials for contract negotiations with hospitals |
Revision module
| | Upcoding avoidance |
| | Materials for revision checks |
References
| | Všeobecná zdravotná poisťovňa |
| | Dôvera zdravotná poisťovňa |
| | Union zdravotná poisťovňa |
