Market Insights Basics: Billing

The billing pages are available for the Operational Metrics tab and provide insight to a variety of metrics. Below you will find the definitions for the column headers.

Included in this article:

• Why is this important and how can this data help me?
• Definitions

Note:

• For patient privacy, the smallest number displayed in annual admits, discharges, died at home, and readmits is11.
• The Market Intelligence Data used in this program is derived largely from Medicare and is dependent on Medicare’s reporting. To determine the reporting period for the year selected, please refer to the Market Data Reporting Periods article.

Why is this important and how can this data help me?

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Definitions

Operational Metrics- Home Health

• Name: Name of home health agency and NPI
• Annual Admits: Number of admits of home health agency within the last four full quarters
  • *Early is determined by a value of 1 or 2 in the first position of the HIPPS code on the claim (example code: 1AB21)
  • **Institutional are the claims with a "2" in the first position
• % Institutional (Early Billing Period): Percentage of early period claims that are institutional.
• CMW (Early Billing Period): Average CMW of the early period claims.
• Billed Amt (Early Billing Period): Average billed amount of the early period claims.
• Non-Therapy Visits (Early Billing Period): Average number of non-therapy visits on the early period claims.
• Therapy Visits (Early Billing Period): Average number of therapy visits on the early period claims.
• LUPA% (Early Billing Period): Average % of early period claims with a LUPA indicator.
  • *late is determined by a value of 3 or 4 in the first position of the HIPPS code on the claim (example code: 1AB21)
  • **institutional are the claims with a ""4"" in the first position"
• % Institutional (Late Billing Period): Percentage of late period claims that are institutional.
  
• CMW (Late Billing Period): Average CMW of the late period claims.
  Billed Amount (Late Billing Period): Average billed amount of the late period claims.
  Non-Therapy Visits (Late Billing Period): Average number of non-therapy visits on the late period claims.
  Therapy Visits (Late Billing Period): Average number of therapy visits on the late period claims.
  
• LUPA% (Late Billing Period): Average % of late period claims with a LUPA indicator.