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Conduct your facility's audits with a dash of PEPPER

Health Care Auditing Strategies, March 1, 2006

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How one organization jumpstarted its audit program

Although the Hospital Payment Monitoring Program (HPMP) offers free tools to help hospitals reduce payment errors, it doesn't mean that you don't have to put in some hard work. One of the most useful aspects of the HPMP is the Program to Evaluate Payment Patterns Electronic Report (PEPPER), a comparative data report generated quarterly that allows organizations to compare their performance in key target areas with national and state median averages.

Because PEPPER reports only include aggregate claims data that show whether facilities deviate from the norm, hospitals should conduct their own audits to determine whether the potential errors on the PEPPER reports are actual errors, said Kathy Newton , RN, MS, who worked on the medical necessity audit program at Salt Lake City-based Intermountain Health Care (IHC), a nonprofit integrated healthcare delivery system.

Newton spoke about the topic with Anita Orenstein, RHIT, CCS, CCS-P, health information systems compliance coordinator for IHC, during the American Health Information Management Association's 77 th convention and exhibit in San Diego.

This is an excerpt from a member only article. To read the article in its entirety, please login.

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