From Denial to Recovery:Upgrading Your Approach to DRG Downgrades

Duration: 1 hour

DRG downgrades significantly threaten hospital revenues. Payers continue to change the rules of the game. Unlike traditional denials, DRG downgrades are “hidden denials,” often initiated by audit firms and may span months, or even years, from the patient’s discharge. To manage this challenge effectively, hospitals must shift their thinking - spanning from DRG identification to the appeals processes. This new webinar dives into the heart of the DRG downgrade challenge, offering insights and strategies to turn potential revenue losses into opportunities for financial resilience. 

Join “From Denial to Recovery: Upgrading Your Approach to DRG Downgrades” and learn insights into root causes, proactive management tactics, and the value of strategic partnerships. Attendees will leave equipped with practical solutions to optimize denials management processes and ensure financial stability. Key takeaways:

  • Gain a comprehensive understanding of DRG downgrades, including their evolution and impact on hospital revenue.
  • Learn how to identify "hidden denials" quickly and effectively.
  • Discover how to structure your appeals process to combat DRG downgrades successfully, including the importance of educating your staff on routing and leveraging insights from upheld appeals to strengthen future cases.
  • Learn real-world strategies to minimize DRG downgrade risks during contract renegotiation and documentation processes. 
  • Explore the benefits of a cross-functional approach to managing DRG downgrades, involving HIM teams, coders, and clinical documentation specialists.
  • Learn from evidence-based strategies for successful payer appeals and contract renegotiations to safeguard your revenue. 




Annabelle Seippel
Vice President
Denial Management Services


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