How to Put Your PEPPER Results Into Action

The Program for Evaluating Payment Patterns Electronic Report, or what we call around here, the PEPPER, is a unique tool we use to support inpatient auditing and compliance efforts.

This electronic report interprets statistical data from your hospital against their Medicare-Severity diagnosis related groups (MS-DRGs) data. The PEPPER then identifies areas where you may be at risk for improper payments due to the common billing, coding, and admission issues that are statistically related to those DRGs.

But, what are you supposed to do with those results?

Well, the first step is identifying what a possible “high-risk” result is within one of your target areas. This is done by determining your facility’s likelihood of risk, in relation to comparable groups by national, or geographically-isolated regions. Then, depending on your target area, these results can indicate the need for corrective action plans to your coding and auditing plan.

But creating and putting an action plan into place is a bit tricky, if at first you don’t even know how to use the PEPPER. That’s why I sat down to dive a little deeper and explore how you can get the most out of this awesome report. It’s called “The PEPPER and You: How to Easily Improve Your Audit Program, One Outlier at a Time,” and it will teach you:

• How to Audit Based On Your Facility’s Results
• What Qualifies as High-Risk Areas in Your Organization
• When to Implement Best Practices to Improve Your Coding Compliance