User Guide

Workflows that get cases paid

Step-by-step walkthroughs — from first case entry to claims submission, plus connecting your hospital systems and switching regions.

Pre-Submission DRG Simulation

Revenue capture & DRG optimization

01
1

Enter the case

Diagnoses (ICD-10-AM), procedures (SBS/ACHI), age, sex, LOS and discharge disposition. The form validates code formats as you type.

02
2

Run deterministic grouping

The licensed AR-DRG v9.0 engine assigns the DRG with a full 12-step trace — every decision is auditable, no black box.

03
3

Review AI suggestions

The AI coder proposes additional codable detail with confidence scores. Every suggestion is guard-railed (no invented codes) and requires human approval.

04
4

Accept & re-group

Accepting a suggestion re-runs the grouper instantly, showing the DRG and reimbursement delta before you commit.

Quick Reference

Configure Payer Tariffs

Facility → Tariffs: MOH CY2021 baseline, shadow-billing scenarios and contract-specific weights.

Browse DRG Codes

Full AR-DRG v9.0 catalogue with MDC partitions, severity splits and national price weights.

AI Assistant

Ask case-level questions — "why did this land in 901Z?" — with grounded answers from the trace.

Keyboard Shortcuts

K search · G+R group & run · ⌘S save case · ? shortcut overlay.