The Case for hbRecon: Comparing Clinical Registry Data and Claims-Based Auditing Tools


Learn how integrating claims-based audits with clinical registry data-based audits like hbRecon provides more actionable insights to optimize financial and clinical performance.


Conducting coding audits is crucial for healthcare organizations in maintaining accurate billing, compliance with regulations, revenue integrity, and quality improvement. In turn, audits provide insight into optimizing coding practices, ensuring the delivery of the highest-quality care, and identifying missed opportunities for appropriate reimbursement. When performed more granularly, audits allow for optimizing the coding processes, accurately capturing all eligible services and procedures while minimizing financial and legal risks.

Historically, claims-based audits have been the standard practice; however, registry data-based audits provide an alternative, nuanced insight into each episode of care and associated event. While claims-based solutions utilize billing data to investigate the revenue cycle journey, hbRecon uses clinical registry data, which provides unique insights into uncovering coding errors that lead to missed revenue opportunities.

The Difference Between Clinical Registry Data and Claims Data

So, how do clinical registry data and claims data differ? Clinical registry data and claims data are valuable information sources in the healthcare industry, but they serve different purposes and have distinct characteristics.

Clinical registry data from sources such as the American College of Cardiology (ACC), the Society of Thoracic Surgeons (STS), Extracorporeal Life Support Organization (ELSO), the American Heart Association (AHA), and State Organizations (COAP & CCORP), includes discrete data elements that contain detailed clinical information about patients, diagnoses, procedures, and outcomes. It is particularly useful in auditing the clinical processes and outcomes of specific medical procedures or conditions.

On the other hand, claims data refers to information collected from insurance claims submitted by healthcare providers for reimbursement purposes. This coded data source includes details about the services provided, such as procedures performed, diagnoses, medications prescribed, and associated costs. However, information for each claim is limited, and it doesn’t capture all aspects of a person’s treatment or health – many things must be inferred.1

Expanding Your Toolkit for Effective Auditing

Both clinical registry data and claims data are instrumental in medical data auditing. Claims data is typically used for financial audits and to assess the appropriateness and accuracy of billing and reimbursement practices, aiming to ensure coding accuracy, compliance with payer requirements and regulatory standards, and integrity of the submitted claims data. On the other hand, clinical registry data provides deeper clinical insight to determine if the claims’ codes appropriately represent the services provided and diagnoses assigned, revealing any missed opportunities for revenue capture due to miscoding. This increased specificity allows auditors to assess adherence to clinical guidelines, identify variations in care, and evaluate patient outcomes.

When segregated, the audits’ data sets lose efficacy. For example, a claims-based audit may determine the claim’s coding to be accurate, but this audit alone cannot determine if additional, necessary coding was omitted due to insufficient provider documentation or missteps in translating clinical language into coding language, especially around MCC and CC conditions. However, clinical registry data-based audits, analogous to the hbRecon-based audit, can reveal potentially missed diagnoses and/or treatment codes, reducing the risk of undercoding or missing revenue opportunities.

The integration of both audit types provides a more comprehensive and accurate assessment of healthcare quality, outcomes, and financial performance. With this synergistic approach to healthcare delivery, it’s possible to ensure that both clinical and financial aspects are aligned and optimized. This is where hbRecon’s use of clinical registry data in conjunction with claims data in the audit process demonstrates its distinctive superiority when uncovering errors in revenue capture.

Harness the Power of Clinical Registry Data With hbRecon

When it comes to revenue capture, the following factors demonstrate why clinical registry data offers superior results:

  1. Clinical Specificity and Coding Accuracy. hbRecon analyzes clinical registry data with detailed discrete & structured clinical information about a patient encounter, including diagnoses, procedures, treatments, and outcomes. This level of specificity allows for an accurate and comprehensive comparison of the services provided and the services billed, leading to improved revenue capture.
  2. Comprehensive Data. Clinical registry data often includes information beyond what is captured in claims data. It may include additional clinical measures, patient-reported outcomes, and quality indicators that provide a more comprehensive view of the patient’s condition and treatment. One clinical registry module alone can warehouse over 2,000 data elements in a single visit. With the hbRecon toolkit, this additional information can support accurate documentation and coding, leading to improved revenue capture.
  3. Quality Improvement. Clinical registry data is often used for quality improvement initiatives, clinical research, and benchmarking. These activities focus on optimizing patient outcomes and care processes, which can indirectly impact revenue capture by enhancing the quality and efficiency of care delivery. hbRecon allows users to review all relevant clinical registry, financial, and coding data in one location.
  4. Patient Acuity. This is where hbRecon’s use of clinical registry data shines again, capturing a better picture of the patient’s acuity – because if the coding is wrong, patients may appear healthier or sicker – lending to a more accurate CMI. From there, hbRecon translates that into the associated diagnosis-related group (DRG) code, adding a CC or MCC when applicable. This benefits the cardiovascular population by better reflecting their actual patient acuity, CMI, and severity of illness, which makes way for appropriate quality improvement initiatives and medically indicated clinical research, ultimately enhancing patient outcomes and care processes.
    Beth Kennalley, a quality professional with one of hbRecon’s major hospital clients, shared what she found most valuable about implementing hbRecon in terms of efficient and accurate billing: “The ability to be able to compare two independent chart abstractions is invaluable but would take too much time to do manually to be useful. This tool allows us to do this, find multiple errors quickly, and promptly submit this information for correction. The tool has reassured us that our billing is accurate in these areas.”

Beth shared that hbRecon’s monthly review of abstraction and coding differences has taken less and less time, and her organization has improved performance in both areas. Efficiency is critical to her ability to quickly and accurately review both data sets to ensure they accurately reflect the case performed.

hbRecon: Translating Clinical Data for Coding Specificity

hbRecon’s phased approach for clinical registry data auditing is a valuable tool for increasing revenue capture with its unique clinical registry and coding data dataset, providing detailed and specific clinical information about patient encounters, allowing for accurate and complete coding based on the documentation of services provided.

Is your healthcare organization ready to discover alternate revenue streams through the hbRecon toolkit? Our platform can integrate clinical registry and coding data sources to algorithmically analyze and determine recommended billing codes and identify probable coding mismatches and rebilling opportunities.

Schedule a discovery call today: https://www.heartbase.net/social-discovery-call


Sources

MIT OpenCourseWare (Dec 13, 2018) 4.3.3 Healthcare Costs – Video 2: Claims Data https://www.youtube.com/watch?v=WYrDTn37m-I

Heartbase, Inc. Certified in STS CHSD v6.23.2

CHICAGO, IL – We are excited to announce that heartbase™ is officially certified by the STS  for Version 6.23.2 of the STS Congenital Heart Surgery Database. On June 13th, 2023, at 2 pm CT, heartbase clinical specialist Carmen Ernst, RN, BSN, will hold a special training class covering the ins and outs of this version. Heartbase customers can click here to register.

From the STS website:

“The STS Congenital Heart Surgery Database (CHSD) is the largest database in North America dealing with congenital cardiac malformations. The CHSD contains more than 600,000 congenital heart surgery procedure records and currently has more than 1,000 participating physicians, including surgeons and anesthesiologists.”

Participation offers:

  • A standardized format for data collection to assess the care of patients undergoing congenital cardiothoracic procedures.
  • Semi-annual performance outcomes reports in a format that allows comparison of local outcomes against national standards.
  • An optional anesthesiology component, which enhances data collection and quality assessment for improving the care of patients undergoing cardiothoracic procedures and surgery.
  • Analysis of major outcomes and process-of-care measures that impact congenital heart surgery patients.
  • Complexity scoring to evaluate the clinical characteristics of your practice.

If you’re a CHSD data manager or abstractor and would like to take a look at our new forms, please contact heartbase Client Account Manager Alex Potanos to schedule a review session. 

About heartbase, Inc.

Heartbase™ is a privately-held company founded in 1992 and designed to be intuitive & centered on the needs of the clinician. Since our inception, we have known that the most effective way to develop a robust and reflexive software platform is through collegial partnerships with our clinical & financial users. Working directly with our customers – listening to their concerns and honoring their suggestions for improvement – allows us to build a tool that is fast, efficient, and tailored specifically to the individual needs of each healthcare institution.

Our primary major business lines are the following: hbCOR, Data Capture & Reporting; hbAnalytics, Realtime Clinical & Financial Dashboards; hbRecon, Coding Reconciliation & Revenue Generation; & hbNote, Data First Structured Reporting.

Heartbase, Inc. Certified in STS/ACC TVT v3


CHICAGO, IL – We are excited to announce that heartbase™ is now officially certified by the ACC-NCDR for Version 3 of the STS/ACC TVT Registry Database.

Highlights of the heartbase™ TVT module include:

  • Integration & Interoperability with other heartbase™ registry events.
  • Interoperability options from other hospital systems such as Epic Clarity, allowing for pre-population of discrete fields.
  • A comprehensively streamlined & customizable electronic DCF, improving upon the flow and functionality of the ACC Online Tool, with options such as role-based access.
  • Simplified reporting with the hbQuery Tool, with measure reporting and other standard reports to follow.
  • Planned integration with the hbRecon Module to ensure TVT cases are correctly coded and billed, maximizing reimbursement.
  • Planned hbAnalytics update to include measure reporting and associated breakout reports.

If you’re a TVT data manager or abstractor and would like to take a look at our new forms, please contact heartbase Client Account Manager Alex Potanos to schedule a review session. Previously led group demonstrations were recorded, and are available on the hbKnowledgebase.


About heartbase, Inc.

Since 1992, heartbase™ has provided health care centers with the most technologically innovative and clinically intuitive data management and analytic solution in the industry. Working collegially with its immense network of users, heartbase™ has created a vast library of reporting tools that provides its clients with complete control of their hospital-owned clinical data. Heartbase’s revolutionary hbCOR platform propels clinical performance, aligns clinical data with registry requirements, and unites health care systems from across our network to the most comprehensive reporting repository in the industry.

Heartbase, Inc. Certified for ACC-NCDR Auxilary Dataset Shockwave Intravascular Lithotripsy (IVL) Dataset for Collection & Submission


CHICAGO, IL – Heartbase is officially certified for the ACC-NCDR Auxiliary Shockwave Intravascular Lithotripsy (IVL) Dataset v1.0 for the CathPCI registry. This optional update has been included as part of the hbCOR v7.5.02 update package, no additional downtime will be required for sites that are interested in participating.

Highlights of the heartbase ACC-NCDR Auxiliary Shockwave Intravascular Lithotripsy (IVL) Dataset v1.0:

  • Complimentary update – no annual or set up fees.
  • Shared Data Entry Tool with the ACC-NCDR CathPCI registry.
  • Shared reporting with ACC-NCDR CathPCI registry including an interactive user-friendly query tool.
  • Integration across all heartbase registries including ACC-NCDR, STS, & GWTG.
  • Optional interoperability with the EHR and other hospital systems.

If you’re an ACC-NCDR CathPCI data manager or abstractor and have any questions, please contact heartbase trainer Carmen Ernst for more information.

About heartbase, Inc. For 30 years, heartbase has provided inventive cardiac database and reporting solutions to hospitals across the United States through a dedication to clinician-focused design and client-centered collegial partnerships. Through this commitment, heartbase has pioneered the most innovative and clinically intuitive tools for standardized & custom registries (STS, ACC-NCDR, GWTG, CMS, ELSO, State, & Custom datasets), advanced analytics (interactive dashboards & ad-hoc querying), system interoperability (EHR & other hospital system interfacing), and financial & coding reconciliation (toolkits to identify areas for increased reimbursement).

Heartbase, Inc. Certified in STS General Thoracic Surgery Database v5.21.1


CHICAGO, IL – We are excited to announce that heartbase is now officially certified by the Society of Thoracic Surgeons to accept and submit data for the newest version of the General Thoracic Surgery Database (GTSD) Registry. Version 5.21.1 will go live beginning with July 1st surgeries, and our customers will be given the opportunity to begin working with the new version upon installation.

The changes to the new registry version do not end with the name. A few notable changes that users should expect in STS GTSD v5.21.1 include:

  • One DCF for all Procedures.
  • Collection of ECOG only on analyzed cases.
  • Procedure weighting with the highest weight assigned Primary Procedure. Secondary Diagnosis is no longer collected.
  • 92 New Fields; 169 Deleted Fields; and 30 Definition Changes.
  • Updated Data Specifications and Data Dictionary.
  • All NQF Measures have been retired.
  • Optional Customization: Sites can retain both the secondary diagnoses and NQF measures. Please contact heartbase support if you’re interested in this customization.

To better prepare our customers for the changes to the GTSD Registry, heartbase clinical specialist Carmen Ernst will hold a special training class on June 29th at 1 pm CT outlining updates to v5.21.1 along with a review of the updated heartbase web-form and number DCF. Heartbase customers can click here to register for this class.

If you’re an GTSD data manager or abstracter and would like to take a look at our new forms, please contact heartbase sales associate Alex Potanos to schedule a review session.

About heartbase, Inc. Since 1992, heartbase™ has provided health care centers with the most technologically innovative and clinically intuitive data management and analytic solution in the industry. Working collegially with its immense network of users, heartbase™ has created a vast library of reporting tools that provides its clients with complete control of their hospital-owned clinical data. Heartbase’s revolutionary hbCOR platform propels clinical performance, aligns clinical data with registry requirements, and unites health care systems from across our network to the most comprehensive reporting repository in the industry.

Heartbase, Inc. Now Supports the ACC-NCDR CathPCI Risk-Adjusted Measures

Standardized Bleeding & Risk Adjusted Bleeding, In-Hospital Risk Adjusted Mortality & 30-Day Risk Adjusted Mortality, and Risk Adjusted Acute Kidney Injury & Risk Adjusted Dialysis

CHICAGO, IL – Heartbase now officially licenses the ACC-NCDR CathPCI Adjusted Measures for CathPCI: Standardized Bleeding & Risk Adjusted Bleeding, In-Hospital Risk Adjusted Mortality & 30-Day Risk Adjusted Mortality, and Risk Adjusted Acute Kidney Injury & Risk Adjusted Dialysis. This update will be available in both the standard hbReporting and hbAnalytics platforms.

Highlights of heartbase’s support of the CathPCI Risk-Adjusted Measures include:

  • Network, Hospital, Provider, and Patient-Level Drill-through with real-time analysis of outliers.
  • Integration of the risk-adjusted measures into the Executive Summary reports – with additional breakout dashboards.
  • Optional financial integration with the heartbase Financial Module.

If you’re an ACC-NCDR CathPCI data manager or abstracter and have any questions, please contact heartbase Account Manager Alex Potanos (apotanos@heartbase.net) for more information.

About heartbase, Inc. Since 1992, heartbase™ has provided health care centers with the most technologically innovative and clinically intuitive data management and analytic solution in the industry. Working collegially with its immense network of users, heartbase™ has created a vast library of reporting tools that provides its clients with complete control of their hospital-owned clinical data. Heartbase’s revolutionary hbCOR platform propels clinical performance, aligns clinical data with registry requirements, and unites health care systems from across our network to the most comprehensive reporting repository in the industry.

STS Adult Cardiac Version 4.20.2 – Heartbase Certified

06.19.2020, CHICAGO, IL – We are excited to announce that as of June 19th, 2020, heartbase is officially certified by the Society of Thoracic Surgeons to accept data for the newest version of the Adult Cardiac Surgical Database. Version 4.20.2 will go live beginning with July 1st surgeries. As one of the first vendors to be certified, we are thrilled that the new forms have already been deployed to the majority of our clients, and we will work diligently to provide our users with the service and support they need as they begin this enormous new undertaking.

The changes to the new registry version do not end with the name. A few notable changes that users should expect in STS ACSD v4.20.2 include:

  • Revisions & changes to 1,000+ fields
  • An Updated Data Dictionary
  • Data submission through IQVIA process

In preparation for this version change, heartbase staff has led preview sessions on May 28th and June 9th. On July 21st, at 1 pm CT, heartbase clinical specialist Carmen Ernst will hold a special training class covering the ins-and-outs of this version change. Heartbase customers can click here to register.

If you’re an Adult Cardiac data manager or abstracter and would like to take a look at our new forms, please contact heartbase sales associate Alex Potanos to schedule a review session.

About heartbase, Inc.Since 1992, heartbase™ has provided health care centers with the most technologically innovative and clinically intuitive data management and analytic solution in the industry. Working collegially with its immense network of users, heartbase™ has created a vast library of reporting tools that provides its clients with complete control of their hospital-owned clinical data. Heartbase’s revolutionary hbCOR platform propels clinical performance, aligns clinical data with registry requirements, and unites health care systems from across our network to the most comprehensive reporting repository in the industry.

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