Overview
The Explore page for Marketscape Insights for HME/Infusion has seven different tabs - six tabs for different referrer types and one tab for billing Organizations. This article covers the Billing Organizations tab.
Select the tab you want to open by clicking on the text in the tab.
Each tab will display different metrics, and some of the available features on the page will change.
For an overview of the features and tools on the Explore page, see The Explore page.
In this article
Filters
The following filters are available under the Billing Organizations tab.
In short, the filters allow you to find billing organizations with metrics that align with specific parameters of interest to you.
In most cases, you will start by setting the Code Set filter and then you will set the Location filter. For some users you will only have access to a single code set, which will save you a step.
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Code Set - If your company specializes in providing specific services or products, by using the Code Set filter, you can limit the table to hospitals that align with the correct code set(s) of interest.
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Location - In almost every instance of using the Explore page, set the location filters to limit the table to hospitals in a specific territory. You can choose any number of locations, including, for example, two counties or cities in adjacent different states.
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Organization Type - the Organization Type filter allows you to limit metrics shown in the table to a specific organization type.
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You can select multiple code sets at the same time. For more information on how to use filters effectively, see Filters - Overview and Strategy.
Understanding the Metrics
The table below includes a brief definition of the columns in the Explore page table for the selected tab.
The following image shows all possible metrics in the Billing Organizations Explore table.
Metric name |
Description |
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| (Organization) Name |
The organization's name - taken from the NPPES database.
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| NPI | The organization's NPI - taken from the NPPES database. | |
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Street Address/City/County/ State/ZIP Code/Telephone |
Information in these columns is taken from the NPPES database from the Primary Practice Address section.
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| Code Set | The listed HME/Infusion code set based on a list of HCPCS codes | |
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| Assigned User(s) | This column displays any users from your company who have the listed home health agency assigned to them. | |
| Claim Counts | All | Sum of estimated claims filed with the listed organization NPI for all claims billed during the most recent 18 months for the listed code set. The purpose is to quantify the claim volume for the listed code set where the listed organization was either the billing organization or likely influenced the supply based on Trella's algorithm. |
| Medicare FFS | Count of estimated claims filed with the listed organization NPI for claims billed through Traditional Medicare FFS during the most recent 18 months for the listed code set. The purpose is to quantify the Traditional Medicare FFS claim volume for the listed code set where the listed organization was either the billing organization or likely influenced the supply based on Trella's algorithm. | |
| Patient Counts | Total - All Payers | Estimated count of distinct patients who had a claim filed with the listed organization NPI for claims billed through any payer (Medicare FFS, MA, Medicaid, Commercial, Other) during the most recent 18 months for the listed code set. |
| Medicare FFS | Estimated count of distinct patients who had a claim filed with the listed organization NPI for claims billed through Traditional Medicare FFS during the most recent 18 months for the listed code set. The purpose is to quantify the Traditional Medicare FFS distinct patient count for the listed code set where the listed organization was either the billing organization or likely influenced the supply based on Trella's algorithm. | |
| MA | Estimated count of distinct patients who had a claim filed with the listed organization NPI for claims billed through Medicare Advantage during the most recent 18 months for the listed code set. The purpose is to quantify the Medicare Advantage distinct patient count for the listed code set where the listed organization was either the billing organization or likely influenced the supply based on Trella's algorithm. | |
| Medicaid | Estimated count of distinct patients who had a claim filed with the listed organization NPI for claims billed through Medicaid during the most recent 18 months for the listed code set. The purpose is to quantify the Medicaid distinct patient count for the listed code set where the listed organization was either the billing organization or likely influenced the supply based on Trella's algorithm. | |
| Commercial | Estimated count of distinct patients who had a claim filed with the listed organization NPI for claims billed through a Commercial plan during the most recent 18 months for the listed code set. The purpose is to quantify the Commercial plan distinct patient count for the listed code set where the listed organization was either the billing organization or likely influenced the supply based on Trella's algorithm. | |
| Other | Estimated count of distinct patients who had a claim filed with the listed organization NPI for claims billed through an insurer other than Traditional Medicare FFS, Medicare Advantage, Medicaid or a Commercial plan during the most recent 18 months for the listed code set. The purpose is to quantify the Other distinct patient count for the listed code set where the listed organization was either the billing organization or likely influenced the supply based on Trella's algorithm. Other patients will typically consist of VA, Tricare, Workers Comp or Unknown payers. | |
| Rank |
Decile rank that represents the number of claims the organization filed for one or more of the respective codes (equipment or medication) within the code set; decile rank of 10 represents the highest volume.
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The name is a link to open the Analyze page for the selected organization.
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