The Outpatient Utilization Report provides a granular look at a hospital’s Medicare OPPS caseload. It concentrates on the twenty highest volume medical diagnoses which typically represent more than 20% of total. It details patient claims, average charges, average cost, average payment, and outlier amounts.
The report also details the Top 20 Ambulatory Payment Classifications (APCs) and the Top 20 procedures. For these categorizations it details patient claims, units of service, average charge, average cost, and average payment. Lookups are also provided in case information is desired for an APC or a procedure that is not in the top 20.
Service statistics are also provided by revenue code. This is a robust report that supports executive oversight of the Medicare line of business and helps to identify any unexpected variations.