Provider Scorecards
Per-provider performance dashboards with coding patterns and education plans.
B
Dr. Sarah Chen
ImprovingOrthopedic Surgery
142 encounters coded
94%
92%
88%
3.2
Avg Codes/Encounter
4.8%
Denial Rate
$682
Revenue/Encounter
142
Encounters
Education Recommendations
- Consider laterality specificity for bilateral joint conditions — use .1/.2 suffixes consistently
- Modifier 59 usage: document distinct procedure site or separate incision more clearly in operative reports
A
Dr. James Patel
ImprovingPain Management
118 encounters coded
96%
97%
94%
2.8
Avg Codes/Encounter
2.1%
Denial Rate
$345
Revenue/Encounter
118
Encounters
Education Recommendations
- Excellent documentation of fluoroscopic guidance details — continue current practices
C
Dr. Maria Lopez
Needs AttentionPhysical Medicine & Rehabilitation
96 encounters coded
87%
84%
74%
2.1
Avg Codes/Encounter
8.9%
Denial Rate
$178
Revenue/Encounter
96
Encounters
Education Recommendations
- E/M documentation often supports 99215 but coded as 99214 — review MDM elements to justify higher-level visits
- Include time-based documentation for prolonged visits exceeding typical E/M time thresholds
- Capture chronic condition HCC codes at each relevant encounter for Medicare patients
- Timely filing: ensure claims are submitted within 90 days — 1 claim denied for late filing this month
B
Dr. Michael Torres
Psychiatry
84 encounters coded
94%
91%
90%
2.4
Avg Codes/Encounter
5.2%
Denial Rate
$248
Revenue/Encounter
84
Encounters
Education Recommendations
- When coding 90792 (psychiatric eval with medical services), document the medical examination component to differentiate from 90791
- Include standardized assessment scores (PHQ-9, GAD-7) consistently to support medical necessity
B
Dr. Angela Rivera
ImprovingBehavioral Health
68 encounters coded
96%
93%
92%
2.0
Avg Codes/Encounter
3.1%
Denial Rate
$145
Revenue/Encounter
68
Encounters
Education Recommendations
- Consider add-on codes (90833, 90836) when psychotherapy is performed during an E/M visit