What method is commonly used by payers to compare billing frequencies of providers?

The method commonly used by payers to compare billing frequencies of providers is data mining. This technique involves extracting and analyzing large amounts of data to identify patterns, trends, and anomalies in billing practices. Payers utilize data mining to efficiently review claims and identify outliers or unusual billing behavior that could indicate fraud, abuse, or simple coding errors. By establishing benchmarks and comparing individual provider billing frequencies against these standards, payers can ensure more consistent and compliant billing practices across the healthcare landscape.

Utilization reviews primarily focus on assessing the appropriateness and necessity of services provided to patients rather than directly comparing billing patterns. Peer evaluations involve reviewing the performance and practices of providers against their colleagues but do not usually involve direct analysis of billing data in the way that data mining does. Service auditing is a process of reviewing specific services for compliance or accuracy, but this too does not typically extend to the broad comparative analysis of billing frequencies that data mining does. Therefore, data mining stands out as the method best suited for the comparative analysis of billing frequencies among providers.