What ProgenyHealth sees that Health Plans may be missing

The increasing costs of NICU cases are partially attributed to situations where claims are submitted for the newborn’s admission with a single revenue code level that reflects a higher resource use intensity than is documented in the records for the duration of care, resulting in higher than expected costs to the health plan.

To successfully manage the cost of NICU cases in a DRG environment, there are a number of drivers affecting cost that need to be understood and managed. 

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