Claims Data is “Big Data”

Marie White

Marie White

One of the new buzzwords these days is “big data.” But what exactly is big data? According to the fine folks at Wikipedia, “big data is a broad term for data sets so large or complex that traditional data processing applications are inadequate.” In the world of Medicare, big data is claims data.

Medicare Part A and B claims are processed by the Centers for Medicare and Medicaid Services (CMS) and then summarized in a document called the Provider and Statistical Reimbursement (PS&R) Summary Report. Each provider is responsible for requesting this summary report when the annual cost report is prepared.

The PS&R system has numerous reports that may be generated in addition to the summary report. Payment Reconciliation Reports (also known as Detail Reports) contain detailed, claim-specific data that supports the summary reports.

Providers are permitted to request detail reports, which can be analyzed and compared to internal data and help you better understand the Medicare reimbursement you are receiving.

Tip #6:

Ensure you have access to the PS&R system and are familiar with the steps to request a report.

Users must have an ID and password to access the system. Apply early, as there’s an approval process to obtain these.

Guidance is available on the CMS website:

PS&R Provider Community

Questions? Please contact Marie White at 612.253.6546 or mewhite@eidebailly.com.

 

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