Expert Insight

Simplify your claims analysis with Advisory Board’s Outpatient Grouper

Unlock the potential of your outpatient claims data with Advisory Board's Outpatient Grouper. With over 20,000 procedure codes condensed into 1,400 distinct groups, discover how this tool can streamline your claims analysis and improve decision-making.
adobestock-485224449

Outpatient volumes are difficult to count

Health systems need to be able to count volumes across care settings to make informed planning and investment decisions. On the inpatient side, that’s easy: one encounter equals one claim and one MS-DRG code. However, outpatient volumes are more challenging. A single encounter can generate multiple claims, each with multiple procedure codes. Counting claims or codes in the outpatient setting results in overcounting and masks the total value of an encounter.

To address these challenges, we created our proprietary Outpatient Claims Grouper to retrospectively count coded encounters. The Grouper condenses an array of codes and descriptions into single, high-level procedure groups, subservice, and service lines. This tool utilizes a grouping algorithm designed to count each patient visit once, regardless of the number of services received, and categorizes it under the most clinically significant procedure in documentation for the visit.


SPONSORED BY

INTENDED AUDIENCE
  • Hospitals and health systems

AFTER YOU READ THIS
  • You'll understand the advantages of Advisory Board’s Outpatient Claims Grouper.
  • You'll know how to access the Outpatient Claims Grouper.
  • You'll understand how Advisory Board tools analyze outpatient claims.

Don't miss out on the latest Advisory Board insights

Create your free account to access 1 resource, including the latest research and webinars.

Want access without creating an account?

   

You have 1 free members-only resource remaining this month.

1 free members-only resources remaining

1 free members-only resources remaining

You've reached your limit of free insights

Become a member to access all of Advisory Board's resources, events, and experts

Never miss out on the latest innovative health care content tailored to you.

Benefits include:

Unlimited access to research and resources
Member-only access to events and trainings
Expert-led consultation and facilitation
The latest content delivered to your inbox

You've reached your limit of free insights

Become a member to access all of Advisory Board's resources, events, and experts

Never miss out on the latest innovative health care content tailored to you.

Benefits include:

Unlimited access to research and resources
Member-only access to events and trainings
Expert-led consultation and facilitation
The latest content delivered to your inbox
AB
Thank you! Your updates have been made successfully.
Oh no! There was a problem with your request.
Error in form submission. Please try again.