OIG / CMS Bell Curve & Under Payment Solution


Know your E&M coding RISK STATUS in real-time, at all times!

Audit Proof Your Practice – For the first time ever, due to data published by CMS, you can see how Medicare views your E&M coding frequency. Live in fear no longer of an OIG or CMS audit!

  • Real time reporting keeps you aware at all times
  • CMS Bell Curve data is specific to your specialty
  • Over coding places you at risk of an audit
  • Receive real-time alerts when you approach the curve

Where Other Bell Curve Programs Fail – It is only within the context of a medical billing and practice management system that Bell Curve reporting can be proactive rather than re-active.

  • Other Bell Curve reporting solutions are forensic
  • “After-the-Fact” reporting cannot alert you of errors
  • Real-time data can only be produced within a PMS
  • Know your under coding Delta at all times

Specialty Specific Bell Curve Data

The bell curve data published by The Centers for Medicare and Medicaid is specific to over 30 medical specialties allowing our practice management and medical billing software to tell you:

  • Your specialty specific exposure to an OIG or CMS audit
  • If you are over coding, or under coding
  • If revenue is being lost due to under coding
  • How to keep each level of service in line with utilization benchmarks for your specialty

Bell Curve Software Comes Standard in Our Enterprise Edition

When you subscribe to the Enterprise Version of our Practice Management/Medical Billing Software, you automatically receive the invaluable reporting capability that allows you to stay far from a CMS audit.

  • Know your E&M coding RISK STATUS in real-time, at all times

How We’re Different from Other Software

Ordinary OIG and CMS Bell Curve software offers you a forensic portrait of your audit exposure. But embedding the bell curve analysis within thePracticeSuite practice management system takes you from re-active to proactive.

  • Real-time intelligence on your E&M coding

Become Pro-Active Rather than Re-Active

Our software helps you understand the utilization of CPT codes prone to audit review. Why wait until after the fact to find out that your evaluation and management coding frequency has placed you at risk of inviting an OIG or CMS audit. Only PracticeSuite medical billing software offers Over Coding Alerts that trigger as you reach the curve.

 

Are you over-coding? Are you under-coding?

Medical necessity of a service is the overarching criterion for payment. No one purposely over codes, but under-coding does happen, usually when a physician fears a denial for a complicated and extended evaluation. But when this happens it means lost money. PracticeSuite will help you never be pressured into under coding ever again.

  • Know your under coding Delta at all times.

Bell Curve analysis is available for the following ambulatory specialties:

  • Allergy/Immunology
  • Cardiology
  • Colorectal surgery
  • Cardiac Surgery
  • Dermatology
  • Diagnostic Radiology: Non Invasive
  • Emergency Medicine
  • Endocrinology
  • ENT
  • Family Practice
  • Gastroenterology
  • General Surgery
  • Pediatric Medicine
  • Gynecological Oncology
  • Hematology/Oncology
  • Internal Medicine
  • Interventional: Pain Mgmt
  • Nephrology
  • Neurosurgery
  • Neurology
  • OB/GYN
  • Ophthalmology
  • Orthopedic Surgery
  • Pain Management
  • Pediatric Medicine
  • Plastic and Reconstructive Surgery
  • Physiatry
  • Podiatry
  • Pulmonary
  • Radiation Oncology
  • Rheumatology
  • Urology
  • Vascular Surgery

Bell Curve analysis is available for the following services and specialists:

  • Individual orthotic personnel certified
  • Individual prosthetic personnel certified
  • Individual prosthetic/ort
  • Medical Supply Company with registered pharmacist
  • Ambulance Service Supplier
  • Public Health or Welfare Agencies
  • Clinical Psychologist (Billing Independently)
  • Portable X-Ray Supplier (Billing Independently)
  • Audiologist (Billing Independently)
  • Physical Therapist in Private Practice
  • Rheumatology
  • Occupational Therapist in Private Practice
  • Clinical Psychologist
  • Clinical Laboratory (Billing Independently)
  • Single or Multispecialty Clinic or Group Practice
  • Registered Dietician/Nutrition Professional
  • Pain Management
  • Mass Immunization Roster Biller
  • Radiation Therapy Centers
  • Slide Preparation Facilities
  • Peripheral Vascular Disease
  • Vascular Surgery
  • Cardiac Surgery
  • Addiction Medicine
  • Licensed Clinical Social Worker
  • Critical Care (Intensivists)
  • Hematology
  • Hematology/Oncology
  • Preventive Medicine
  • Maxillofacial Surgery
  • Neuropsychiatry
  • All other suppliers, e.g., Drug Stores
  • Unknown Supplier/Provider
  • Certified Clinical Nurse Specialist
  • Medical Oncology
  • Surgical Oncology
  • Radiation Oncology
  • Emergency Medicine
  • Interventional Radiology
  • Optician
  • Physician Assistant
  • Gynecological/Oncology
  • Unknown Physician Specialty Code
  • Hospital
  • Skilled Nursing Facility
  • Intermediate Care Nursing Facility
  • Nursing Facility, Other
  • Home Health Agency
  • Pharmacy
  • Medical Supply Company with Respiratory Therapist
  • Supplier Of Oxygen Or Oxygen Related Equipment
  • Pedorthic Personnel
  • Medical Supply Company with Pedorthic Personnel
  • Medical supply company not in 51-53
  • Rehabilitation Agency
  • Ocularist
    [SOURCE: CMS/OIS PART B ANALYTICS REPORT]