Benchmarks are a tool commonly used by practices to determine whether a provider’s evaluation and management (E/M) services reported fall within the same utilization as their peers.
When a provider deviates outside of the expected use of E/M codes, there is a potential risk for an audit. Comparison of data, without understanding the meaning, may result in unnecessary internal audits and an increased level of anxiety within the practice. The results may cause a provider to unnecessarily alter coding habits to fit within the national range. Learn how to analyze benchmark data and apply the results to your practice without causing undue anxiety. In this workshop, we will review E/M benchmark data, compare data, analyze the meaning of the data, determine if and what to audit based on the results of the comparison, and audit medical records.
Why is this topic important? Misinterpreting benchmark data as it is applied to your practice can have a devastating effect. Understanding how to apply benchmark data effectively allows you to utilize the information to benefit your practice and provide a foundation to determine a provider’s risk of audit and identify potential risk areas in the practice.
Who would benefit from this topic? Managers involved in billing and/or coding departments, practice managers, billing companies, auditors, coders, providers.
How would this benefit the individual and/or their company? Effective use of benchmark data allows you to utilize the information to benefit your practice and provide a foundation to determine a provider’s risk of audit and identify potential risk areas in the practice.
What information/new skills will the attendee take away from this webinar? Effective application of benchmark data, understanding the risk involved based on comparison the benchmark data, and auditing skills.
About The Author
Katherine Abel, CPC, CPMA, CPC-I, CMRS
Katherine is director of curriculum and manages planning for curriculum improvement and development. She is a prior health care consultant with more than 20 years of experience in health care, including working for a practice management organization, auditing, compliance, extensive work in billing offices and adjudicating claims for commercial payers. She has experience with system conversions and high-growth billing operations. Prior to joining AAPC, Ms. Abel was a billing administrator for Stat Solutions, LLC and served as vice president of Operations for PriCare, Inc. Katherine is also an ICD-10 trainer for AAPC.
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retransmitted, shared or disseminated. A computer with a high speed Internet connection
and speakers (or headphones) is recommended to connect to the event.