HEALTHCARE
PRICING DATA
TIMELY, COMPLETE
For more information or questions,
Hospital Summary
High level charge analysis, compare your Hospital to the market average of your peers. The analysis includes: Inpatient cases and days, emergency room visits, outpatient surgery and diagnostic procedures. Multiple pages include both summary and detail charge and stat data.
DRG Summary
Average charge per case for each DRG is listed in this report. Review a head to head analysis of DRG charges versus your selected peers. The analysis is divided in four major service groups: Medical, Surgical, Obstetric, and Psychiatric.
DRG Service Line Summary
Detail analysis as to what revenue centers and charges comprise an Inpatient case. Identify service lines that are not in line with your peers by service group (Medical, Surgical, OB and Psych). The analysis includes Pharmacy, Materials/Central Supply, Operating Room and 19 other service lines.
DRG Service Line Detail
Key a DRG to retrieve detail by case for all lines grouped on the Cost Report, as many as 22 service lines. The analysis includes the specific Provider detail plus peer group by hospital to enable a detail product line analysis.
Hospital Room Rates
Inpatient room rate charges detailed by Medical, Surgical, Obstetric , and Psychiatric claims.
Hospital Outpatient Summary
The report includes a comprehensive analysis of 40 key products, to compare your hospital to the specific market peers. Measures are broad to cover the entire outpatient business in several pages, specific to identify areas that need attention.
Outpatient HCPCS
This ad hoc report, allows the User to enter codes to retrieve HCPCS charge detail in the CMS OPPS limited and CAH expanded charge data sets. Data is presented for the local Hospital defined peer market, county and state level, as well as UB and Carrier market analysis..
APC Status T Detail
Review detail line item charges at the claim level for any APC Status T procedure performed by your hospital or your peers. This analysis provides the detail necessary to fully understand the charge structure of your peers to improve your hospitals charge practices.
PARA Data Availability
| Data Source |
| Date Available |
Description |
|
Inpatient Data
|
|
May
|
The Medicare Provider Analysis and Review (MEDPAR) file contains records for 100% of Medicare
beneficiaries who use hospital inpatient services. The national file consists of approximately
12 million records.
|
|
Outpatient Hospital Data
|
|
June
|
This file contains select claim level data and is derived from 2009 hospital outpatient PPS claims,
updated through June 2010, that is, claims for services furnished on or after January 1, 2009 through
December 31, 2007 that were received, processed, paid, and passed to the National Claims History file
as of June 30, 2010. This file includes more than 58 million claims, for services paid under the OPPS,
including multiple and single claims.
|
|
Healthcare Service Providers, including Physicians, Surgery Centers, Diagnostic Imaging Centers, Urgent Care, & Independent Laboratory
|
|
August
|
This file is a 100% summary of all Part B Carrier and DMERC Claims processed through the Common
Working File and stored in the National Claims History Repository. The file is arrayed by carrier,
pricing locality, Healthcare Common Procedure Coding (HCPC), modifier 1, modifier 2, specialty, type
of service and place of service. The summarized fields are total submitted services and charges,
total allowed services and charges, total denied services and charges, and total payment amounts.
|
|
Outpatient Critical Access Hospital Data
|
|
November
|
This file contains claim level data and is derived from 2009 hospital outpatient claims, updated through
June 2010, that is, claims for services furnished on or after January 1, 2009 through December 31, 2009
that were received, processed, paid, and passed to the National Claims History file as of June 30, 2010.
This file includes claims for all Hospitals including CAH, Cancer and Children's.
|