HPMP Resources
The Hospital Payment Monitoring Program (HPMP) continues reducing the number of unnecessary inpatient admissions and coding errors, which was begun by the Payment Error Prevention Program (PEPP).
Primaris will continue to perform full case review on the hospital medical records sampled monthly by the Clinical Data Abstraction Center (CDAC/DynkePRO). The data from those reviews, along with other data available from the Centers for Medicare and Medicaid Services (CMS), will be analyzed for patterns of payment error. Primaris may implement hospital or topic specific rapid-cycle quality improvement projects based on the findings.
Hospitals should continue to evaluate their internal processes to guarantee that only patients requiring inpatient services are admitted and that DRG assignments are accurately billed the first time. New processes should be implemented, or existing processes revisited, for areas identified as needing improvement.
Click here for tools and resources related to hospital payment monitoring.
Related: HPMP One Day Stay Project (ODS)