Health Information Management

News: Latest PEPPER released

CDI Strategies, June 7, 2012

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The latest Program for Evaluating Payment Patterns Electronic Report (PEPPER) was released May 24. CDI specialists may access the report via their facility QualityNet account, located here: www.qualitynet.org.

The PEPPER allows each hospital to compare its Medicare billing practices with other hospitals:
  • in the same state;
  • in the same Medicare administrative contractor (MAC) or fiscal intermediary (FI) jurisdiction, and
  • against national statistics.
These comparisons enable a hospital to determine if it is an outlier, significantly differing from other short-term acute care hospitals. The report released to each hospital will be hospital specific, focusing on inpatient discharges in 30 areas potentially at risk for improper Medicare payments.  
 
The data in each free report is presented in tabular form, as well as in graphs, that depict the hospital’s target area percentages over time. The data also includes reports on the hospital’s top medical and surgical DRGs for one-day stays.  All of the data tables, graphs, and reports in the PEPPER are designed to assist the hospital in identifying potential overpayments as well as potential underpayments.
 
Editor’s Note: To learn how to use the PEPPER at your facility participate in the June 12 audio conference “PEPPER 2012: Improve your organization’s Medicare claims profile.”
ACDIS members can read more in the CDI Journal article “Put PEPPER to proper use,” published in April 2011.



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