Working with Metrics

Metrics are statistical measures that evaluate medical coding and documentation. They are specific to Data Elements on a claim (such as HCFA, UB, or CDT) and determine whether errors can be assigned to that particular Data Element for a specific project. The user can modify, copy, add, or delete the base set of metrics included in Audit Manager to meet your organization's auditing goals.

Choose the desired version of Audit Manager+ to see the relevant steps:

• Audit Manager+ Enterprise
• Audit Manager+ Multi-Account

Audit Manager+ Enterprise

Follow these steps to start working with Metrics using the Enterprise version:

• Navigate to the Admin Manage Audit Settings and select the Metrics tab. A Metrics list page will be displayed.

• This screen displayed the metric ID, name, type, data elements status, and other important information.
• Under the Action menu, the user can also choose the following option, if required:
  • Show/Hide - This allows the user to hide or show columns in the list portion of the grid.
  • Add Metric - It allows the user to add a new metric. The user can refer to the Add Metrics and follow the instructions.
  • Edit Metric - Allows the user to edit predefined metrics. The user can refer to the Edit Metrics and follow the instructions.
  • Copy Metric - Allows the user to create a duplicate of the metric.  Select the metric you want to copy by clicking on the box at the end of the row.
  • Delete Metric - Allows the user to permanently delete the metric details from the database.  Once deleted, the metric cannot be restored.  Metrics cannot be deleted if they have been used in an audit.
  • Run Report - It allows printing the data displayed in the grid when the report option is selected. This allows users to search for specific rows and then create a report.
  • The Toggle button allows users to switch between viewing active and inactive metrics on the Metric List page.

Audit Manager+ Multi-Account

Follow these steps to start working with Metrics using the Multi-Account version:

• Navigate to the Admin Manage Settings and select the Metrics tab. A Metrics list page will be displayed.

• This screen displayed the metric ID, name, type, data elements status, and other important information.

• Under the Action menu, the user can also choose the following option, if required:

  • Show/Hide - This allows the user to hide or show columns in the list portion of the grid.

  • Add Metric - It allows the user to add a new metric. The user can refer to the Add Metrics and follow the instructions.

  • Edit Metric - Allows the user to edit predefined metrics. The user can refer to the Edit Metrics and follow the instructions.

  • Copy Metric - Allows the user to create a duplicate of the metric.  Select the metric you want to copy by clicking on the box at the end of the row.

  • Delete Metric - Allows the user to permanently delete the metric details from the database.  Once deleted, the metric cannot be restored.  Metrics cannot be deleted if they have been used in an audit.

  • Run Report - It allows printing the data displayed in the grid when the report option is selected. This allows users to search for specific rows and then create a report.

• The Toggle button allows users to switch between viewing active and inactive metrics on the Metric List page.

Add Metrics

Steps to add a new Metric:

• To add a new Metric, click on the Action menu and select Add Metric. The Add Metric Details screen will be displayed.

• Metric Id - A system-assigned identifying number of the metric in the metrics dashboard, which will be created and updated automatically.

• Metric Type - Metrics are linked to auditable data components. Audit Manager facilitates the auditing of all data components on HCFA, UB, or ADA claim forms. The Metric Type specifies the claims to which the metric applies. Applying metrics to various claim types or combinations of claims offers the advantage of reusing metrics while minimizing maintenance.

  • All Header: data elements that specify the patient's and encounter's demographic details. For instance, the patient's gender or date of birth.

  • All Line - components pertain to the services provided, such as the date of service, location of service, and procedure code.

• Data Element - Choose the desired data element associated with the metric from the dropdown menu. Note: if you are entering a metric for chart-level or audit-level measures, this field is left blank.

• Deduction Category - Select the desired deduction category to group metrics and create a more manageable set for reporting. This categorization is optional and does not pertain to audit-level metrics.

• Metric Name - Enter a unique name identifying the metric. Type the desired metric name in the field.  

• Procedure Codes - Enter the specific CPT or HCPCS procedure codes for the metric, if available. Enter each code, separated by a comma.  Audit Manager does not currently support code ranges.

• Score Type -Select the desired score type from the dropdown menu. This Score Type identifies whether or not the errors identified for the data element are included in calculating the audit score or as information for the provider and/or coder:
   

  • Score: Errors assigned to this type are included when tabulating the audit score.

  • Report: Problems identified with this type of score are only for the provider and/or coder and are not included in the audit score.

• Associate Checklist - Select the checklist you want completed for the Data Element and/or Procedure code (CPT, HCPCS, and CDT) from the dropdown list.

• Effective Date - Select the date on which the metric becomes active or is set to be implemented.

• Termination Date - Select the date on which the metric should no longer be applied or the rule changes.

• Error Options - This is a high-level description/classification of errors. We recommend 1-3 words such as Incorrect, Missing, Overcoded, etc. More detailed descriptions of errors are best made using the supporting text in Checklists or Chart Level Comments. To add the Error options, follow the steps below:

  • Click on the Add icon and enter the desired error information.

  • Click on Add. The error option and score will be added under the error option list.

  • The user can also add multiple errors using the same process.

  • The added score can be changed if needed.

  • The priority icon allows the user to sort the listing of added errors. The user can select the priority icon and move it according to their priority listing.

  • Action Icon Delete allows users to remove the error from the list.

  • Action Icon Edit allows the user to edit the desired error option.

• Note - It allows the user to add additional information to the metric.
• After adding all the required elements, click Save and choose one of the following options:
  • Save - Saves the metric and returns to the Metrics view page.
  • Save & Next - Saves the current item and moves directly to the next one, streamlining the setup or review of multiple entries.
• Users can also filter the metrics list by selecting the desired metric ID, name, type, data element, effective date, status, or associated checklist directly from the dropdown.

Edit Metrics

Steps to edit existing Metric:

• Select the checkbox located before the metric name you want to edit.
• Navigate to the Actions and select Edit Metric. The Edit Metric window will be displayed.
• Update the necessary fields, such as name, category, score type, method, or other required information.
• After adding all the required elements, click Save and choose one of the following options:
  • Save - Saves the metric and returns to the Metrics view page.
  • Save & Next - Saves the current item and moves directly to the next one, streamlining the setup or review of multiple entries.

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