Root Cause to Revenue: Winning the Battle Against DRG Downgrades 

Hospitals and health systems face mounting revenue challenges from denials to evolving payer tactics, making financial performance increasingly difficult to sustain. This raises an important question “What do you know about your DRG downgrades?” In this session Executive Vice President Tami Knobbe and Vice President, Denials Management Services Erica Strick at CorroHealth will discuss DRG downgrade trends and explore common root causes to better understand denials at the source. Attendees will gain practical, evidence-based strategies to strengthen revenue, transforming curiosity into actionable solutions for a more resilient revenue cycle. 

Key Takeaways:

• Learn how analyzing DRG downgrade trends helps identify root causes and enables prevention of non-appealable denials before they require appeal 
• Explain the benefits of technology, data analytics, and cross-departmental workflows between denials and CDI teams to address issues early and optimize revenue outcomes 
• Explore how contract management, including language in payer contracts, can shield organizations from denials and underpayments