How to Run the Report
Reports > Billing > 15.09 PPS HIPPS Summary
Almost all Medicare reporting and calculating is based on the Thru date of the episode, but agencies have to decide for themselves how they want to measure their stats. The main thing in comparing reports across different time frames is to make sure the selections are the same; don’t run a report for 2009 with from dates and a report for 2010 with thru dates.
The visit counts come from the episode. Choosing All Episodes (RAP created) will have the case mix calculated correctly, but the visit counts could be wrong. The visit counts on this report come from the EOE claim, so if any EOE claims haven’t been created yet for the time frame of the report, those visit counts would be zero,even though the case mix weight would be used in calculating an average.The case mix weight comes from the HIPPS code, which is there as soon as the RAP claim is created.
o From Dates= If you choose From, then the episodes with a From Date between the dates is selected;
o Thru Dates= Thru dates will choose episodes with the Thru date in the specified range.
o Program(s) / Team(s) = Filter report by entering program or team number(s).Or leave blank to select all.
How to Read the Report
o Weight = Mix Weights
o HIPPS = Number of episodes per weight
o # Pats = Number of patients per weight,
o % = Episodes with that HIPPS code vs total episodes.
o PT / OT / ST / SN / MSW / HHA = The average visits per episode.
o Avg Days = Average length of episode.
o Average HIPPS weight
o Average number of episodes per beneficiary.
On the last page:
o Therapy = Episodes are episodes with six or more therapy visits
o Non-Therapy = Episodes with less than six therapy visits.
o LUPA = Episodes have four or fewer visits total.
o Non-LUPA = Episodes have more than four visits total.
o Outlier = Total number of outlier episodes.