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Prepayment coding reviews for Coventry Medicare claims beginning March 1, 2019

As a reminder, we are expanding our prepayment coding reviews for specific diagnosis-related group (DRG) claims. This will affect all Coventry Medicare claims. As always, we want to ensure that the claims correctly show the services you give to our members. We will review DRG facility claims based on case history. To make sure we review your claims quickly and accurately, please provide all necessary clinical information up front. If we need more information, we may ask you for medical records.


This program does not apply to providers in the following states: Connecticut, Massachusetts, Maine, New Hampshire, Rhode Island, Texas and Vermont.