Patient Accounts 

Sampling & Randomization

An auditor needs good selector tools to help them in their auditing. This makes good selector tools essential, and ReviewMate has a special focus on creating easy-to-use tools for all scenarios to help empower your auditors. A variety of different querying parameters are integrated for every auditing account to help extract the exact accounts you need from your database. ReviewMate also includes randomized selection as an additional way to query random accounts, helping to reduce the chance of errors, keeping your records spick and span (and compliant!).

Not only does ReviewMate contain flexible manual selection tools, all queries and sample selections can be customized to run automatically, allowing your auditor to tailor their auditing process to their needs, which improves productivity and reduces mistakes. Routine audits are the standard when it comes to end-user firms. With ReviewMate, these tasks are only a few clicks away from being automated, allowing tasks or findings to be automatically populated.

Sample Selector and Record Randomizer

Sample selector was developed to provide the audit and quality management teams with a simple way to select a random or targeted set of patient accounts for code review. ReviewMate Sample Selector is considered the most comprehensive and advanced tool for patient account sampling. Record samples are selected based on customized logical rules created and managed by your in-house team, who can utilize our ReviewMate rules engine.

ReviewMate Sample Selector leverages the associative, commutative, and distributive laws of algebra to select and manipulate the sets of patient accounts, as needed. This example shows various created groups based on a timeframe, or certain coding conditions, such as DRGs, or reimbursement amounts, or even a combination of multiple coding circumstances.

Account Randomization

Random sampling ensures that results obtained from the sample should approximate what would have been obtained if the entire population had been measured. It is vital to pick a comprehensive sampling set to represent performance for the coders and providers. ReviewMate runs a mathematical randomization algorithm to select the sample records.

Sampling Automation and Workflows

Healthcare code auditing is considered a continuous practice; therefore, a sample group can be automatically selected to recur on your team’s chosen schedule. ReviewMate Sample Selector is able to create randomized or focused reviews on a daily, monthly, quarterly, or annual basis. It will streamline the auditing process and save valuable time and effort. The most popular use case is to select X number of random patient accounts per coder every X number of days. The system is capable of determining whether to add accounts to an existing review or create a new audit, as needed, based on the customizable review family data pattern.

Sample Selector leverages your customizable workflows to manage code revisions performed on the case at any stage (Pre and Post Billing). For example, if reviewer #1 updated the EMR/Encoder with their findings and wanted to pass the account for a secondary CDI review, the new revised version will follow a different workflow and get routed to reviewer #2. ReviewMate has revision controls to keep track of all revisions of each account.

Key features of Sample Selector workflows are:

  1. Manipulation of patient accounts in a review such as Copy, Move, Delete, Skip and Update records based on certain customizable triggers.
  2. Auto assign reviewers based on departments, coders, or other conditions.
  3. Create customizable email notifications based on triggers.
  4. Create customizable tasks to reviewers or audit managers.

Manual Sampling

If an electronic interface isn’t available from your EMR or abstracting system to move the audit records into ReviewMate, manually uploading your patient accounts into our Sample Selector module is always an option. All of the same great features and workflows remain available.

Any particular questions or inquiries? We'd like to hear from you.