Evaluation and Management Updates 2023: Training and Q&A

Join us for a complimentary 90-minute training session reviewing the 2023 E&M documentation guidelines and requirements and providing examples on how to improve your internal documentation processes to ensure appropriate reimbursement and avoid compliance issues.

Big Changes in 2023 for Ambulatory Surgery Centers

The Centers for Medicare and Medicaid Services (CMS) have created over 50 new C-codes (C7500–C7555) for ambulatory surgery centers (ASCs) that affect many procedures. These codes were created to allow additional payment for packaged services for ASCs.

How to Stay Ahead of Payer Audits by Data Mining Your Claims

External audits are rapidly returning to full operating force following a lull that took place amid the worst of the COVID-19 pandemic. Amidst a time of shrinking operating margins and heightened scrutiny by federal healthcare contractors, providers are seeking to focus on the benefits of technology-driven internal auditing.

How to Rationalize Chargemaster Prices

Have you ever wondered how hospital prices became so irrational? As is often the case, things changed incrementally. Hospitals and healthcare systems have experienced years of inadequate inflationary update factors, often reduced by factors such as presumed over-coding under the federal inpatient and outpatient prospective payment systems.

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Is Your Staff Struggling with How to Bill Lab Services? 4 Steps to Better Results

If your organization is struggling with coding laboratory services consistently and accurately, here are the four steps you need to take.

How to Comply With (and Exceed) the CMS Hospital Price Transparency Rule Requirements

CMS penalties have dramatically increased in 2022, and providers must take heed before CMS and a legislative gauntlet arrive at their front door.

Panacea Healthcare Solutions, a Leading Healthcare Mid-Revenue Cycle Technology and Services Company, Receives Growth Investment from Firmament

ST. PAUL, MINNEAPOLIS, August 24, 2022 —Panacea Healthcare Solutions announced today that it has received growth capital from Firmament, a leading provider of structured equity capital solutions to small- and medium-sized enterprises. Firmament’s investment will fuel innovation and expand Panacea’s product suite through the acquisition of Holliday & Associates and First Healthcare Compliance. The combined company will be a leading provider of healthcare revenue cycle and compliance software and services to over 600 hospitals, health systems, physician practices, and accountable care organizations across the United States.

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Whitepaper: Hospital Zero-Base Pricing®: A Novel Approach to Establishing Rational Chargemaster Prices

Today’s environment necessitates that healthcare CFOs and financial managers can explain, document, and defend the rationale behind their CDM prices. This whitepaper discusses why financial managers who previously had optimized their chargemaster prices or inherited irrational chargemasters should consider a hospital zero-base pricing initiative.

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Case Study: Achieve Significant Efficiencies through a Comprehensive Audit Program to Ensure Compliant Coding and Optimal Reimbursement

A large, multi-specialty practice with more than 1,000 physicians and allied health professionals has been able to achieve significant efficiencies by consolidating a number of core administrative activities, particularly billing, reimbursement, and other financial operations.

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Evaluation and Management (E&M) Split (or Shared) Visits – 2022 Summary of Changes

The 2022 Final Rule defines split (or shared) visits as evaluation and management (E&M) visits in the facility setting that are performed in part by both the physician and a non-physician practitioner (NPP) who are in the same group, in accordance with applicable laws and regulations.

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Is Automation the Answer in Auditing?

Ask Kathy Pride, and she’ll tell you: there are two ways for healthcare providers to perform proactive auditing of their claims. There’s the old way—and there’s the better way. The […]