Infusion Reimbursement Diagnostic Services™ (IRDS)

IRDS

noun   |   i∙r∙d∙s   |   \ ī-r-dē-es \

  • Most comprehensive and advanced healthcare revenue cycle solution on the market for infusion operations
  • 12 month retrospective charge capture, payment and coding analysis which uses proprietary algorithms to uniquely analyze every single line item transaction created from infusion center operations
  • Not a sampling or an audit

Infusion Revenue Diagnostic Services (IRDS) uses a software program designed from the ground up to fulfill one mission:

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Identify and capitalize on payor and provider errors inherent in billing and collecting for infusion drugs, injectable drugs and their associated administration services

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Why IRDS?

  • Drug costs are skyrocketing up to $40,000 per Tx
  • Constantly changing billing requirements and reimbursement
  • Increasing payor mistakes on drug claims
  • Complex administration coding rules
  • Specialty drugs are estimated to grow 400% between now and 2020
  • 340 B reimbursement is scheduled to be greatly reduced in 2018
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Problem Areas Addressed

  • Data Entry
  • EMR configuration
  • CPT coding
  • HCPCS accuracy
  • Claim processing
  • Payor contracts
  • Inventory Mangement
  • Pharmacy
  • Business Office operations
  • Medical necessity
  • Software/System integration
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Benefits

  • Finds additional revenue from services provided up to 12 months in arrears
  • IRDS is not an audit – every line item charge and payment analyzed
  • IRDS findings can be incorporated into a provider’s compliance program
  • Immediately use the data to make impactful operational and other changes on a go forward basis
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Proven Success

  • GHS has reviewed $1+ Billion in charges and payments
  • IRDS has identified millions of dollars in missed reimbursement
  • IRDS has identified significant opportunities in every engagement
  • Works with all billing/HIS software platforms
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Case Study

Standard IRDS 12 month retrospective analysis
270 Bed Non-Profit hospital
# lines analyzed by IRDS – 749,000
# lines identified by IRDS - 503
Missed charges identified- $750,000
Underpayments identified- $225,000
Total Additional Collections - $490,000

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Cost

  • Payment is on contingency basis
  • Paid only on actual incremental collections identified by IRDS
  • We’re paid only after incremental revenue is collected by Client
  • No additional costs. All expenses borne by GHS regardless of outcome
  • No risk – just reward
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Clients

  • Any provider or facility that bills for infusion or injectable drugs and services in an outpatient setting.
  • IRDS works effectively with hospital systems, multi-specialty groups, any size or specialty physician groups, cancer centers, etc.
  • No client is too small or too large
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The Process

  • Simple data exchange between Client and Guardian
  • IRDS software reviews the data
  • GHS confirms findings via research in Client systems
  • Client receives line item report with documentation to support additional reimbursement
  • Client works claims and pays Guardian after the additional revenue has been collected
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Guardian Guarantee

If our IRDS review is not able to identify any revenue or coding improvement opportunities for you, we will donate $5,000 to your organization or the charity of your choice.