CBRs are educational tools used to provide insight into billing trends. The intent is to assist healthcare providers when performing self-audits of both procedures and billing practices. The Centers for Medicare & Medicaid Services contracts with eGlobal Tech to identify topics and administer the national CBR program.
You can use CBR reports to see how your provider practice or individual practitioner compares to your peers. The peer group is comprised of providers with the same specialty and within the same geographic area. Medicare intermediaries use CBRs to compare utilization across providers within relevant peer groupings. Often we will focus on providers who have accumulated what appear to be excessive services and dollars by conducting a medical review audit known as a probe review.
While the results of some billing comparisons that appear aberrant can trigger a potential audit, they do not necessarily indicate non-compliance with Medicare rules and regulations.