title: Report data identify risk areas for improper payments.
abstract: Hospitals should take several steps in using data from the Program for Evaluating Payment Patterns Report (PEPPER) to enhance compliance efforts and identify risk areas for improper payments: Designate one person to monitor PEPPER releases and download the quarterly report. Review the reports and list all areas where the hospital is most at risk for improper payments. Prioritize at-risk areas with the national comparison, followed by jurisdictional and state comparison. Conduct small-sample case reviews in at-risk areas and determine next steps, such as process improvement or rebilling. Include hospital finance, compliance, legal, case management, and coding experts as part of discussion.
authors: Executive Health Resources, Newtown Square, Pa., USA. drcorrato@ehrdocs.com
authors: Robert R
authors: RR
authors: Corrato
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D003953:Diagnosis-Related Groups / Q000191:economics*; D004469:Economics, Hospital / Q000458:organization & administration*; D019983:Guideline Adherence; D007349:Insurance, Health, Reimbursement; D012308:Risk Management / Q000191:economics*; D014481:United States