New Grouping Platform for Hospital Claims and Encounters

On November 25, 2022, ForwardHealth will move from 3M’s Grouper Plus System (GPS) to the Grouper Plus Content Services (GPCS) platform. These systems are used to group and price inpatient and outpatient hospital fee-for-service claims and HMO encounters. The cloud-based GPCS will provide enhanced support from 3M. In addition, it will generate efficiencies with grouping and pricing of claims and encounters that use All Patient Refined Diagnosis Related Groups (APR DRG) and Enhanced Ambulatory Patient Groups (EAPG) reimbursement methodologies.

Impact to providers should be minimal. ForwardHealth will not be changing any APR DRG or EAPG settings with this upgrade.

ForwardHealth will notify providers when the next quarterly content release will be available containing new International Classification of Diseases diagnosis and procedure codes and new and end-dated Healthcare Common Procedure Coding System procedure codes.

Information on hospital rates and weights is available on the ForwardHealth Portal.