DRG Optimization

As an association or professional society, you are concerned with your services and their representation in the DRG system. But what do you do when members approach you with statements that your existing or new services are not correctly mapped in the reimbursement system?

inspiring-health has been working with German professional societies on this topic for many years. If there is a perception that your services are not or insufficiently represented, we will prepare an initial analysis for you. With the help of publicly available data, we test your hypotheses. We present the results of our analysis to the professional society. If a need for action is identified, we develop a so-called "DRG development project" for you.

01Cost studies

In our cost studies, we review the relevant data from costing houses for you and assess their quality. It is important to determine whether and how the services are represented in the costing hospitals. This gives you the opportunity to have applications rejected by InEK recalculated. Cost studies very often lead to new hypotheses due to the very precise data analysis, which lead to the proposal procedure or to coding proposals for your members.

02Proposal procedure

With the results from the cost study, which were calculated on real data, we have created the basis for you to have your services recalculated via the officially defined proposal procedure of DIMDI and InEK. With proposals for new ICD/OPS or changes to the DRG system, you are on the right track to correctly and optimally map your existing or new services.

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