ReviewMate

ReviewMate InSights

ReviewMate InSights is an analytical, benchmarking, and reporting tool that performs root-cause analysis of common coding errors resulting from your coding audits. InSights is instrumental in determining trending issues in your local database, as well as the larger ReviewMate Community.

Located in the Pickerson Solutions data center, ReviewMate InSights is a centralized database that contains statistical and trending information. It includes all four auditing record types: Inpatient, Outpatient, ASC, and ProFee. The database does not contain any client information, PHI (Personal Health Information), or PII (Personal Identifiable Information). Only statistical information is used to help the ReviewMate Community understand current trends in the coding audit industry.

What is the ReviewMate Community?

The ReviewMate Community is a collaboration of all ReviewMate users, assembled with the intent of improving common issues. With this association, users can leverage InSights for addressing their most problematic coding errors. These types of insights are viewable to users, but they also contribute to artificial intelligence within ReviewMate thus enhancing user experience.

ReviewMate InSights based on local ReviewMate Instance

Clients can create multiple drill-down dashboards to understand trending issues and identified coding errors in their local ReviewMate database. These might include different time periods, coders, or providers. The analysis is configurable and can be narrowed down per client, coder or a specific provider.

The internal InSights dashboard will provide:

  1. Root Cause Analysis: It is critical to understand why specific coding errors are occurring to activate educational plans to address the issues and prevent recurrence.
  2. Drill-Down Reporting: The details of each coding error identified can be extracted with just one click. Details such as the reason for the code change, codes recommended, and location of each account containing that particular code change.
  3. Finding Opportunities: Once coder issues and departmental trending topics are identified, it becomes critical to run a scan against all other records with similar challenges. This ensures a benefit and correction before new records are audited. Risk Manager can be leveraged to perform this function.

ReviewMate InSights based on the ReviewMate Community

In addition to accessing InSights from your local database, users can access statistics and common issues from thousands of ReviewMate users. ReviewMate Community InSights allows users to benchmark their performance for comparison against a large body of users. In the medical code auditing industry, this has never been possible before as there is no standard method of calculating accuracy rates. With ReviewMate Community, all users are using our Gold Standard method of calculating accuracy rates, so users are truly able to compare apples to apples.

Benchmarking

Benchmarking reports can be made for multiple targets. For example, results of coders A, B and C can be compared to the average accuracy found in the ReviewMate Community. Another measure could be conducted internally comparing the individual outcomes of coder A with coders B and C. This is easily quantified using our ReviewMate InSights benchmarking reports.