Client Case Studies

eValuator 835 Case Study

eValuator’s $31M Impact Validated Via 835 Remittance Analysis

Case StudiesHealthcare Claims and ReimbursementPre-Bill Auditing

After implementing eValuator, the client aimed to confirm its financial impact by analyzing 835 remittance data for inpatient claims. A post-payment analysis comparing actual reimbursements with pre-billing predictions validated eValuator’s impact, demonstrating that correcting approximately 2,300 under-coded encounters increased inpatient revenue by over $31 million.

Streamline CaseStudyIllustrations

eValuator Corrects 22% of External Vendor-Coded DRGs, Resulting in $1M Financial Impact Over 90-Days

Case Studies
Coding Accuracy

Facing challenges in hiring inpatient coding staff, the client turned to outsourced coding support. eValuator identified a high DRG change rate associated with the outsourced vendor, resulting in the capture of approximately $600,000 in revenue and averting potential overbilling of over $400,000 in the same quarter of the outsourced vendor’s implementation.