Discovery is a search function that allows you identify healthcare providers and sites that match your best-fit criteria.
It combines billing codes (procedures, diagnoses, prescriptions) with provider- and site-level filters (specialty, geography, payer mix, GPO affiliation, CRM status, and more) to return a ranked list of providers.
Encounter-based Discovery
MedScout supports two types of code sets: Total Claims and Encounters. Code sets based on total claims target all patients who match the criteria present across any claims. An Encounter is the combination of all procedures and/or diagnoses for the same patient, on the same day, with the same provider. A single encounter can span across multiple claims. Encounter-based searches in Discovery enable you to find providers based on combinations of relevant procedure and diagnosis codes occurring together within the same patient, day, and provider window.
Key Capabilities
Target providers and sites by creating code sets around the specific clinical activity that matters to your business — procedures performed, diagnoses treated, or prescriptions written — using CPT, HCPCS, ICD-10, and DRG codes. Save and reuse them across territories, reps, and campaigns without rebuilding from scratch. Code sets can be private or shared at the company level.
Build a New Code Set
Click Discovery in the left-hand navigation panel.
Click on the Code Set drop-down, then click +New
In the New Code Set panel on the right, choose Total Claims (default) or Encounters
If you've selected Total Claims, search for one or more billing codes. Search supports CPT, HCPCS, ICD-10D (diagnosis), ICD-10P (procedure), DRG, and prescription codes.
If you've selected Encounter, create one or more code groups using a combination of conditions (INCLUDE/EXCLUDE and ANY/ALL) and billing codes. Encounter-based code sets can mix CPT, HCPCS, ICD-10, ICD-10P, and DRG codes within the same encounter
Preview and confirm your code set definition.
Enter Volume Name and choose if you'd like the code set to be available just to you (Personal) or to everyone in your organization (Company)
Click Create when finished
Code sets based on total claims are available to use right away, and the results will be shown in Discovery as soon as the code set is created.
Code sets based on Encounters take a few minutes to build.
Volume from the selected codes is shown alongside provider or site names in the resultspanel, sorted highest to lowest by default.
Edit and Delete Code Sets
To edit an existing code set, hover over its name in the Code Set drop-down, then choose the Edit (pencil) icon.
Make changes in the Edit Code Sets panel.
When finished, click Update to save changes to this code set or Save As New to create a copy that includes your changes instead of modifying the original code set. If you are saving a new code set, choose a new name and click Save Volume
To delete an existing code set, hover over its name in the Code Set drop-down, then choose the Delete (trash can) icon.
Click Confirm button in the pop-up window to finish deleting the code set.
To find providers and sites to target, choose the code set and the territory.
Find Providers to Target
Select the area for the search from the Territory drop-down
Choose an existing code set from the Code Set drop-down, or create a new one
Toggle between Providers / Sites,Treating / Referring, and Year Range
Results are shown on the map and as a list. When multiple providers operate in close proximity, you may see a number > 1 on the map. Click on the number to zoom in and see individual providers based on their exact location.
Filters
To filter results, click on the Filter field to open the Filters panel.
If you have saved filters, choose them from the Presets drop-down.
If not, you can add filters ad hoc
Click Apply to update results on the screen.
Advanced filter logic supports Include/Exclude
Ex: "providers who are not primary care"
and Any/All on combinations
Ex: "urologists who do all of these procedures"
Ad-hoc filters include
Site of Care Type
Payer Type
Specialties
Independence Status
Hospital Systems
GPO Affiliations
Open Payments
Medical Schools
Residency
Fellowship
Tags
Provider Lists
CRM Owners
Add providers or sites from Discovery results into a List for downstream workflows.
Select up to fifty providers or sites from Discovery results and click Add to List to save them.
You can choose an existing list from the drop-down or create a new one by clicking + New List
Click Add to List to save
Lists persist independently of the Discovery search that created them, so you can return to a saved set without rebuilding the search
See the FIXME LINKLISTS page for full documentation on managing and using Lists
Good to Know
Result list cap: Discovery returns a maximum of 50 providers in the list view, regardless of total matches. The total volume figure reflects the full result set; the 50 cap applies only to what's displayed for list-building.
Filter applicability varies by entity type: Some filters apply to providers but not sites (e.g., specialty). Switching between provider and site search may invalidate certain filters.
Encounter search performance: Encounter-based searches typically take a few minutes to return results.