1. What is a Utilization Report?
A utilization report is a detailed record of billing data, typically compiled over the last year. This report includes:
Insurance Payer Billed: The insurance company billed for the services.
Date of Service: When the service was provided.
Location (POS): The place of service where the procedure was performed.
Procedure Code: Codes like CPT and HCPC representing the procedures.
Modifier (if applicable): Additional codes that provide extra information about the procedure.
Volume or Units: The number of times a procedure code was billed.
Here is an example of what your Utilization report should look like:
2. Importance of Utilization Reports
Utilization reports are vital for generating accurate outputs and functional tools within Rivet. They allow for precise fee schedule analysis based on specific procedure mixes and utilization quantities. Having the correct input data ensures Rivet can deliver the best insights and recommendations.
3. Building Your Utilization Report in Rivet
Follow these steps to build your Utilization Report in Rivet:
Click on your practice name in the top right corner.
Select "Account settings" from the dropdown menu.
Select “Utilization” from the left menu options under Payers and claims.
Click on “+Upload utilization” on the top right.
Drag and drop your utilization file or browse to select it.
Ensure all columns are correctly mapped. Rivet usually auto-maps, but it is important to verify accuracy. Click on “First row contains headers” if your report contains headers. If not marked it can cause an error with the upload.
If a column is incorrect, click the 'X' next to the header and drag it to the correct column.
Review and submit your report by pressing “Next”.
Click on “Submit” in the Import Utilization modal.
The most recent submission will appear at the top of the list.
4. Storing Your Utilization Report in Rivet
To keep your utilization reports accessible, store them in Rivet:
Click on the folder icon (Payer Documents) at the top right of the page.
Click the "Upload" button in the top right corner.
Select the utilization file you downloaded.
Once the file is selected it will open the Upload modal. Here you can name the file, add a description, add payers, and update the status. Once you verify all information is correct. Click Submit to upload your Utilization.
For further assistance, please contact our support team via chat or email at support@rivethealth.com.
Suggested Next article: Uploading a Chargemaster Report