Selecting Data Elements To Audit

Data Elements are units of information shown in the Audit Worksheet. They provide information to be audited or that is needed during the audit process. Data Elements are used to present information from the medical record or claim in Audit Manager+. Data Elements help identify the information that needs to be audited or is required during the audit process.

Users can choose which data elements appear in the Audit Worksheet and are included in each project. This streamlines the audit process by removing unnecessary data and "noise" from the Audit Worksheet.

Healthicity’s Audit Manager+ also lets users assign custom titles to data elements using your organization’s language, simplifying implementation and cutting staff training time.

There is a tab within the Audit Guideline where you define the data elements needed for each specific project. This is also where you determine whether each data element needs to be audited or is simply displayed to support the audit process. The following are instructions for setting up Data Elements in:

• Click the Data Elements tab to select the elements to include in the audit.

• Click on the Data Element tab. Depending on the claim type selected (professional, facility, or dental), Audit Manager+ will display the data elements typically required for that claim type. However, users can add any data elements for any claim type. 
• Select Data Elements. Click the box at the start of the row to select or deselect each data element. If some data elements are not displayed, click on the View All toggle to see all available Data Elements. If you need a Data Element that is not listed, consider repurposing a similar one. Consult your Client Service Manager (CMS) for assistance and guidance on adding unique data elements to your audits. In certain cases, Healthicity can add custom Data Elements.

• You can also select the master checkbox in the title row to include all available data elements in the list.
• The sorting feature allows users to organize data elements in alphanumeric order and in reverse order.
• Show/Hide Data Elements enables users to display or hide unselected data elements.
• The Provider / Coder / Generic setting lets you define how a data element should be used within the audit. Select Provider if the element specifically relates to the provider’s documentation, or Coder if it pertains to the coding team’s entries. Choose Generic when the data element broadly applies to both roles or serves as a general reference. This choice ensures the Audit Worksheet displays and assesses the information correctly based on the designated role. 
• You can also use the Master checkbox under Provider, Coder, or Generic to quickly apply the selected view type to all data elements. This ensures that all elements are displayed for the chosen auditee type in the Audit Worksheet.
• Custom Display Name allows the user to display a customized name for the selected element. Enter the desired custom name, if desired.
• All data elements are categorized under either Header Purpose or Service Line Purpose. Header Purpose includes elements shown in the Claim Header section, while Service Line Purpose includes those in the Service Line section of the Audit Worksheet. Each row includes a Review/Display dropdown to define the data element's role in the audit. Select Review if the data element should be audited for accuracy, or Display if it’s only needed for reference and not subject to audit.
• Associated Metrics.  Metrics identify the potential errors associated with each specific data element based on coding rules and guidelines. Metrics have assigned checklists that represent the coding rules and guidelines. In the dropdown list, all of the metrics for that Data Element are listed.  Select the metrics you want associated with the project. 

Note: Metrics must be unique based on the combination of Metric Type, Data Element, and Procedure Code. You can create multiple metrics with the same Data Element and Procedure Code as long as each has a different Metric Type. If you assign metrics in which all three fields match, the system will display a validation message and highlight the conflicts until they are resolved.

• Once all the desired Data Elements and Metrics are selected, click on Save.
• Users with access to the Admin menu can update the defined Data Elements and Metrics by navigating to Settings Manage Global Settings Data Elements. Use the Pencil icon to update or modify the Audit Guideline’s Data Elements details as needed.
• Users can also update the Audit Guideline by navigating to Audit Create Projects, clicking the desired project, or using the Pencil icon in the project details column.

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