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New Payor Reporting Tool

The CPR Committee recently introduced its “CPR Reporting Tool,” which was developed as a resource for CPR communications with payers, to HBMA’s website. The tool documents significant quantifiable issues so that CPR and payors can jointly work to solidify reasons for improvement or change on behalf of HBMA membership and was originally designed to address only commercial payor claims issues. It was expanded, however, to include all payors including Medicare and Medicaid and provider enrollment issues.

Using the HBMA Heal The Claims survey conducted in April 2009, CPR developed a Top 10 List of payor issues, from which the reporting tool evolved, as a dynamic real-time survey approach to collecting information from HBMA membership. The tool has been designed using radio buttons and drop down menus—ideal for quick entry—and also features a “Comments” field.

The “Frequency” field is an important part of claims denials. It is meant to capture the amount of times you experience a particular recurring denial program that usually represented a programmatic issues with the payor’s adjudication system.

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