Recoding Gaps

Overview

The Recoding Gaps Dashboard is an essential tool designed to identify and display key data elements that are missing proper coding. By highlighting these gaps, the dashboard enables data analysts and decision-makers to quickly pinpoint areas where data integrity may be compromised. This tool offers a clear visual representation of where recoding efforts are required, facilitating efficient prioritization and resource allocation. By addressing these gaps, organizations can improve data accuracy, enhance reporting capabilities, and support more informed decision-making processes.

Metrics Overview

Tabs Overview

Roster Recoding

There are two sub-tabs included. On the Roster tab there are the following tables:

• Plan Name Selector

• Roster Summary

• Roster Details

On the Original Roster Input tab there are the following tables:

• Original Roster Input Data

• Market Segment & SubSegment Audit

• Plan Name & Metal Level Audit

• Network, Product Type and PCP Req's Audit

Patient Insurance Recoding

There are two sub-tabs included. On the Patient Insurance tab there are the following tables:

• Patient Insurance Summary

• Patient Insurance Recoded

On the Patient Insurance Recoding tab there are the following tables:

• Product ID Selector

• Original EMR Data - Detailed

• Original EMR Data - State and Payer

• Original EMR Data - Segment

• Original EMR Data - Plan Name

• Original EMR Data - Network + Prod Type + Metal Level

Appointment Category Mapping

There are four sub-tabs included. On the Appt Category tab there are the following tables:

• Appointment Category Summary

• Appointment Category Mapping

On the Custom Appt Category tab there are the following tables:

• Custom Recoded Appointment Category Summary

• Custom Recoded Appointment Category Mapping

On the Appt Type tab there are the following tables:

• Appointment Type Summary

• Appointment Type Mapping

On the Appt Status tab there are the following tables:

• Appointment Status Summary

• Appointment Status Mapping

PHM Quality Mapping

The following tables are included:

• PHM Quality Data Sources

• Quality Measure Reporting Trend

• PHM Quality Data Audit

• PHM Value Mapping - Original to Mapped

• PHM Value Mapping - Mapped to Original