Billing Compliance
AUDIT Report  

A line-item analysis of submitted patient claims, to be used to identify potential coding errors in order to prevent or defend against compliance issues.   The report uses a series of "alert codes" to report suspect coding combinations. The reports are specific as to the individual patient and date of service, as well as other billing detail to enable the user to reference the appropriate medical records.

Executive Summary

A collection of reports designed to provide a summary of alert codes, detailed by physician or practice.

Practice Alert Summary

The Practice Alert Summary report will provide, in both viewable and printable form a summary of the practice's alert codes. The detail of this report includes the number of units the system has identified for each alert code, and the associated gross charges. The report also identifies the percentage of gross charges associated with the alert codes in comparison to the practice's total gross charges. This analysis is based on the user defined date range. 

Practice Alert Detail

The Practice Alert Detail report provides a summary of the practice's alert codes detailed by provider. Within each alert code the alert count and associated gross charges are indicated. The report also identifies the percentage of gross charges associated with the alert codes in comparison to the practice's total gross charges.  

Provider Alert
Summary

The Provider Alert Summary report will provide, in both viewable and printable form a summary of the physician's gross charges, gross charges that are associated with the alert codes, as well as the percent of those gross charges in comparison to the physician's and practice's total gross charges. In addition, the report details each alert code and the number of units and gross charges attributable to the individual codes for that physician. This analysis is based on the user defined date range.

Most Frequent ICD-9

A graphical analysis of the physician's or peer's most frequently utilized diagnoses and the associated procedures. In addition, the data can be viewed in spreadsheet form, which identifies usage variances for both the provider and peer view.

CPT-4 Utilization
Per ICD-9

The CPT-4 Utilization Per ICD-9 report provides a graphical and numerical comparison of multiple CPT-4 codes for a selected ICD-9 code for the specified provider.

Most Frequent CPT-4

A graphical analysis of the physician's or peer's most frequently utilized procedures the associated diagnoses. In addition, the data can be viewed in spreadsheet form, which identifies usage variances for both the provider and peer data.

ICD-9 Utilization
Per CPT-4

The ICD-9 Utilization Per CPT-4 report provides a graphical and numerical comparison of multiple ICD-9 codes for a selected CPT-4 code for the specified provider.

E & M (CPT-4)
Utilization

A review of evaluation and management procedures (E&M codes) and the associated diagnosis codes, represented both graphically and in spreadsheet form.

Provider Productivity Analysis

The Provider Productivity Analysis report provides a comparative summary of provider productivity within an organization by specialty.  

CPT-4 Charge Analysis

The CPT-4 Charge Analysis report provides a summary of procedure frequency, charges and average charge per procedure for a chosen provider during a specified period of time.  

ICD-9 Charge Analysis

The ICD-9 Charge Analysis report provides a summary of diagnosis frequency, charges and average charge per diagnosis for a chosen provider during a specified period of time.  

ICD-9 Charge Analysis
by Specialty

The ICD-9 Charge Analysis by Specialty report provides a summary of diagnosis frequency, charges and average charges per diagnosis by specialty.