The Program for Evaluating Payment Patterns Electronic Report (PEPPER), distributed either quarterly or annually depending on the type of facility, contains large amounts of data on how a facility compares to others in the same state, the same jurisdiction (i.e., the same Medicare Administrative Contractor), and nationwide in terms of coding and medical necessity target areas. (Find out more at www.pepperresources.org.)PEPPER identifies when facilities are outliers in their reporting of multiple risk areas. For coding, those areas are:
If patients were already concerned about healthcare organizations' ability to protect their information, a report released in May did nothing to alleviate their fears.
Chart completion, in the traditional sense, typically entails someone reviewing a record to ensure that all components are complete and signed in accordance with organizational policy. Over the years, organizations have revised their policies to meet Joint Commission standards and other directives.
The electronic Program for Evaluating Payment Patterns Electronic Report (PEPPER) contains data for hospitals on MS-DRGs and discharges at high risk for payment errors. Per the opening paragraph of the 2010 PEPPER User’s Guide:
As part of a compliance program, a hospital should conduct regular audits to ensure charges for Medicare services are correctly documented and billed. PEPPER can help guide the hospital’s auditing and monitoring activities.
HIM staff members have a lot on their plates right now, but one more looming deadline needs to be on their radar—the Federal Trade Commission (FTC) will begin to enforce its Red Flags Rule June 1. Hospitals must have an identity theft prevention program in place by that date.
