Profee (Physician's Office) Module

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The Profee (physician’s office) auditing module of ReviewMate provides:

  • Accuracy rates for all elements including:

    • CPT/HCPCS (Current Procedural Terminology/Healthcare Common Procedure Coding System).
    • E&M (CPT codes in the Evaluation and Management chapter).
    • Non-E&M (CPT codes not in the Evaluation and Management chapter).
    • Modifier
    • Service Units
    • Diagnosis (ICD-10-CM and ICD-9-CM)
    • First-listed diagnosis
    • Secondary diagnosis
    • Procedure provider
    • Procedure Date
    • CMS-HCC (Hierarchal Condition Category)
  • Locality fee schedule pricing takes place within the software eliminating the need for auditors to “toggle” between other products and ReviewMate.

  • Optional logic-based E&M Form tool allows auditors to analyze the provider note and determine the correct E&M level. The tool contains 1995 and 1997 criteria for encounters before 2021. The E&M Form is exportable for easy reporting and training.

  • Full suite of references including Coding Clinic, CPT Assistant, Coding Clinic for HCPCS, AHA Coding Handbook, Coders’ Desk Reference, Clinotes and code look-up eliminating the need for an outside product toe perform research.

  • Identification on the screen of codes with CMS-HCC value.

  • Full communication between auditors and coders within the software to discuss findings and recommendations.

  • Reconciliation of rebuttals occurs inside of ReviewMate.

  • Conversations between the auditor and coder are saved and can be accessed by any user.

  • Accuracy rates are available real-time and can be “sliced and diced” to accommodate different situations and date patterns.

  • Extensive library of customizable reports from raw data to Executive Summaries.

  • Customizable dashboards to enhance the user experience.

  • Multiple user levels allow view-only access to any interested parties providing transparency with your organization.

  • “Audit the Auditor” module is available for a higher-level quality check of any review in ReviewMate.