A healthcare system sought to maximize yield from insurance payers to maintain financial health. Increasingly complex managed care contracts, downgraded DRGs and billing and payer discrepancies resulted in lower-than-expected reimbursement.

A healthcare system sought to maximize yield from insurance payers to maintain financial health. Increasingly complex managed care contracts, downgraded DRGs and billing and payer discrepancies resulted in lower-than-expected reimbursement.