Evaluate Your Medicare Audit Risk with a Preliminary Assessment
Take the first step toward safeguarding your organization: Simply enter your provider’s National Provider Identifiers (NPI) into the research bar below and click “Search” to see your Medicare audit risk instantly.
For each metric, there are three columns:
- Physician: This column shows the data associated with the NPI number entered below.
- Specialty: These comparative figures are the median values using all providers of the provider’s specialty.
- Variance: The column reports the variance of the physician to the specialty.
Does your practice have more than 50 providers? Send a list of your NPIs to complianceriskanalyzer@vmghealth.com.
- Interpretation Guide
- Unique Procedure Codes – is the number of unique HCPCS codes reported by the provider.
- Unique Patients – is the total number of unique patients reported by the provider.
- Total Services – is the total number of individual services (or line items and units) reported by the provider.
- Total Allowed – reports the total allowed amount assigned by CMS to the total services reported by the provider.
- Total Payments – reports the total amount paid by CMS to the provider.
- Services per Patient – is the ratio of the total number of services reported per unique beneficiary (patient).
- Services per Patient Percentile – This metric reports the percentile ranking for this provider compared to their peer group for the average number of services provided per unique patient. In our opinion, 75 to 90 (75th percentile to 90th percentile) represents a moderate risk while 90 to 100 (90th percentile to 100th percentile) represents a high risk.
- Payments per Patient – is the average amount paid to the provider per unique patient.
- Payments per Patient Percentile – This metric reports the percentile ranking for this provider compared to their peer group for the average paid amount per unique patient. In our opinion, 75 to 90 (75th percentile to 90th percentile) represents a moderate risk while 90 to 100 (90th percentile to 100th percentile) represents a high risk.
Don’t Stop at Evaluating Your Risk—Minimize It
Go further with Compliance Risk Analyzer®, designed to deliver detailed reporting and predictive analytics across hundreds of providers. Backed by our team of seasoned compliance experts, CRA empowers your organization to catch and prevent compliance risks while optimizing revenue.
Trust VMG Health to empower your organization with the tools you need to navigate today’s complicated regulatory environment.
Control Your Compliance Journey
Book a demo to learn more about how our tool can support your compliance and revenue goals.