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HOMETOWN HEALTH PEPPER REPORTS. HTH PEPPER REPORTS. Information can be found: Federal Register Department of Health and Human Services/Office of the Inspector General . Pepperresources.com. HTH PEPPER REPORTS. What is a PEPPER report?
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HTH PEPPER REPORTS Information can be found: • Federal Register • Department of Health and Human Services/Office of the Inspector General. • Pepperresources.com
HTH PEPPER REPORTS What is a PEPPER report? • Program for Evaluating Payment Patterns Electronic Report • Microscoft Excel Workbook • Information from filed Medicare Claims • Compares your Hospital’s data to state and national information
HTH PEPPER REPORTS Availability: • Short Term Acute Care PPS Hospitals • Long Term Acute Care PPS Hospitals • Critical Access Hospitals • Inpatient Psychiatric Hospital • Rehabilitation Facilities 1st Quarter – October through December 2nd Quarter – January through March 3rd Quarter – April through June 4th Quarter – July through September
HTH PEPPER REPORTS • How do I use this report??? • You will be able to identify the target areas that CMS looks at • You will be able to change your Utilization Review habits • You will be able to identify over or under coding
HTH PEPPER REPORTS Target Areas: • List of target areas can be found on the pepperresourse.com 29 Target areas Why focus on target Areas? • This is what CMS is looking at. This CAN and WILL affect your reimbursement!!!!
HTH PEPPER REPORTS Percentages: • Flag – at or above 80% in risk areas • Flag – lower than 20% for coding-related risk • Look at your Compare Worksheet first.
HTH PEPPER REPORTS Revenue Cycle: • Ancillary Department Managers • Patient Financial Services • HIM • Coder • Utilization Review • CNO • CFO • Compliance officers
HTH PEPPER REPORTS Revenue Cycle Meetings: • Review the PEPPER Report. • Pull reports from your HIS for validation • Review patient records
HTH PEPPER REPORTS Revenue Cycle Plan: • Identify the problem • Develop a plan • Put the plan in place • Monitor for improvement
HTH PEPPER REPORTS Example of plan: • Hospital notices their “readmission” is high. • Pull all records
HTH PEPPER REPORTS One Day Stays… Ugly words but it happens…. READ, LEARN, UNDERSTAND PEPPER REPORTS STUDY, PLAN, DEVELOP, INSTITUTE PLANS RACS ARE USING THIS DATA…. WHY SHOULDN’T YOU?