Clinical Validation in 2025: Back to the Basics—What Changed & How to Win

Clinical Validation in 2025: Back to the Basics—What Changed & How to Win

Presented on August 20, 2025

Understanding DRG (Diagnosis-Related Group) downgrades is essential for professionals working in denial and appeal management, coding, and revenue cycle roles. This introductory webinar will break down the foundational concepts behind DRG downgrades—why they happen, how they impact reimbursement, and what strategies can be used to identify, respond to, and appeal them effectively. Whether you’re new to the field or looking for a refresher, this session will equip you with the terminology, processes, and key documentation considerations needed to navigate DRG downgrade denials with more confidence.

Presenter: 

• Kendall Smith, MD, SFHM, ACPA-C | Chief Medical Officer & Chief Physician Advisor, PayerWatch
• Reggie Allen, MBA, RN, ACM | Chief of Clinical/Business Operations, PayerWatch