Quick RCM AI — our proprietary Agentic AI platform — abstracts every inpatient chart first, surfacing CC/MCC opportunities, POA concerns, and grouper-ready code sets. AHIMA and AAPC certified inpatient coders then validate every DRG assignment, helping maximize appropriate reimbursement while keeping every chart CMS IPPS and OIG audit-ready.
Inpatient Diagnosis-Related Group coding is how Medicare, Medicaid, and most payers determine reimbursement for hospital inpatient stays. Every episode of care is assigned a DRG based on the principal diagnosis, secondary diagnoses, procedures performed, complications and comorbidities (CC/MCC), patient age, and discharge disposition.
Inaccurate DRG assignment — even a single missed CC or MCC — can mean significant revenue loss, claim denials, or compliance exposure. Quick RCM AI abstracts every chart against this logic first; our certified coders then confirm the assignment so your facility captures every dollar it has earned.
Principal and secondary diagnoses captured directly from clinical documentation.
Precise ICD-10 codes applied to diagnoses and inpatient procedures, AI pre-read for accuracy.
MS-DRG or APR-DRG grouper logic maps validated codes to the correct DRG and severity weight.
DRG relative weight × hospital base rate determines the final expected payment.
Full documentation trail, CC/MCC capture, and coder-level quality review on every account.
Every inpatient chart moves through both — never one alone.
Quick RCM AI never finalizes a DRG on its own — an AHIMA or AAPC certified inpatient coder always makes the final call.
From chart abstraction to DRG validation, our certified coders cover every aspect of inpatient revenue integrity.
Quick RCM AI-powered workflows accelerate chart review, flag documentation gaps, and recommend DRG assignments — every recommendation reviewed and validated by a certified coder before it's final.
Accurate principal diagnosis selection, ICD-10-PCS procedure coding, and CC/MCC capture for proper Medicare Severity DRG assignment.
Concurrent and retrospective review of inpatient records to catch documentation gaps before they downgrade a DRG or trigger an audit.
Medicaid and commercial DRG coding that accurately captures Severity of Illness (SOI) and Risk of Mortality (ROM) levels.
Collaborative CDI programs that bridge clinical documentation and coding to improve specificity and DRG accuracy.
Independent validation audits that catch under-coding, over-coding, and errors before claims are ever submitted.
Comprehensive review of previously coded accounts to identify missed revenue and submit corrected claims compliantly.
Present on Admission indicator assignment and Hospital-Acquired Condition screening to protect reimbursement and compliance.
Different payers group inpatient claims differently. Our certified coders and Quick RCM AI are trained across both methodologies.
Medicare Severity DRG is the system CMS uses for inpatient reimbursement under IPPS, classifying patients into one of roughly 760 groups based on diagnoses, procedures, and CC/MCC status.
All Patient Refined DRG is used primarily by Medicaid and commercial payers, adding Severity of Illness (SOI) and Risk of Mortality (ROM) sub-classifications to each base DRG.
Every inpatient coder holds CCS, CIC, or an equivalent credential, with dedicated MS-DRG and APR-DRG specialization.
Our proprietary Agentic AI platform surfaces documentation gaps, CC/MCC opportunities, and POA concerns in real time — before a coder opens the chart.
Every account undergoes multi-level quality review, with accuracy tracked per coder and per facility type.
Flexible staffing models handle surge volume and backlog clearance, with 24-48 hour turnaround for standard inpatient accounts.
SOC 2-aligned infrastructure, encrypted data pipelines, and role-based access controls safeguard PHI at every stage.
A streamlined, Agentic AI-enabled workflow from chart intake to clean claim submission.
Secure EHR access or chart upload. Quick RCM AI pre-reads for key diagnoses, procedures, and documentation cues.
Certified coders assign principal & secondary diagnoses, inpatient procedures, and POA indicators.
DRG grouper is run, CC/MCC checked, SOI/ROM levels validated, and discrepancies flagged for CDI query.
Second-level QA review, with compliance checks against CMS IPPS, PEPPER, and payer-specific guidelines.
Coded data delivered to your billing system, with monthly DRG mix reports and performance dashboards.
Our coders are trained across high-complexity inpatient MDCs and surgical DRG families. Select a specialty to see what's covered.
High-complexity, high-reimbursement DRGs where CC/MCC capture and precise procedure coding directly affect payment.
Stroke, craniotomy, and spinal procedure coding where MCC differentiation carries significant reimbursement weight.
High-volume surgical DRGs where accurate revision and CC/MCC distinction protects appropriate reimbursement.
Respiratory, ventilator, and ICU DRGs — where sepsis and organ dysfunction capture is frequently missed.
Built on a foundation of regulatory compliance, consistent with CMS, OIG, and payer-specific guidelines.
Full alignment with CMS Inpatient Prospective Payment System rules, annual ICD-10 updates, and Official Coding Guidelines.
Coding decisions are documented and defensible, with focus on DRG pairs historically targeted by RAC, MAC, and OIG auditors.
Strict adherence to Uniform Hospital Discharge Data Set guidelines for principal diagnosis selection and sequencing.
All PHI is handled under HIPAA-compliant protocols with encrypted transfers, access controls, and signed BAAs.
We use CMS payment-pattern data to benchmark your DRG mix and identify outlier risk areas.
Coding aligned to Medicare, Medicaid, commercial, and managed care policies — including major national payers.
A coding manager will follow up within one business day.
Tell us about your current volume, DRG mix, and denial challenges. A coding manager will follow up with a straightforward assessment — including where Quick RCM AI could help.
Talk to an inpatient coding specialist about how Quick RCM AI and our certified DRG coders can strengthen accuracy, prevent denials, and speed turnaround for your volume.
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Established in 2022, Alpine Pro Health. delivers accurate, compliant, and efficient medical coding and RCM solutions. Trusted by U.S. healthcare providers for expert-driven, end-to-end services.
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