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Coding Audit Benchmarking: Comparing apples to apples

Gynecologist Sitting Near Medical Equipment

Let me ask you a question: Wouldn't it be nice to benchmark your coder's performance against other coders in the industry?

Up to this point, there has never really been a way to do this. Why? Because there are no standards for calculating accuracy rates. For as many different organizations that exist doing coding audits, there could be that many calculation methods. So, in effect, if you could get accuracy rates from the cross-town hospital and compare them to your own coder's rates, you don't know what is behind their calculations and you may not be comparing apples to apples.

For example: Do they use a scoring system or are they counting the codes one by one? Do they roll up diagnosis, procedure, DRG and disposition into their accuracy rates? I have done some studies on these differing calculation methods and they always resulted in widely varied accuracy rates. In theory, a coding supervisor can boast about how their coders consistently score 95% or above, but do we really know how they got to that calculation? This can lull them into a false sense of security and may leave you with a sense that your coders are underperforming.

Our auditing platform, ReviewMate, uses accuracy rate calculation methods recommended by AHIMA (white paper circa 2008). There are 28 different organizations and hundreds of thousands of auditors in the ReviewMate Community, using the same calculation methods. We have securely and anonymously gathered all of those accuracy rates into one large database called ReviewMate Insights.

Our ReviewMate Insights module will finally allow you to benchmark your coders' performances against a large population providing you with security and confidence of knowing exactly where your coding team stands. This makes our industry stronger and elevates quality for everyone!

Another benefit of using ReviewMate Insights is that you will have access to a listing of the most common coding errors across this large population. You will be able to answer questions like:

  • What are the top 5 diagnosis code errors?

  • What is the #1 most revised principal diagnosis code? or

  • What is the most commonly revised E&M code?

ReviewMate Insights will help you keep your finger on the pulse of known problem-areas and eliminate the tedious work of identifying accounts to audit.

With only a few clicks, you can apply this knowledge to your own data, see where risky accounts may exist, and create an audit for your team!

Contact us for a live demonstration of how our auditing platform can save you frustration and time when it comes to your coding audits.