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Developing a Pricing Strategy for the 2019 CMS Transparency Requirement

In October, Panacea sponsored an HFMA educational webinar on Developing a Pricing Strategy for the CMS 2019 Transparency Requriement.    The one-hour webinar was hosted by the Healthcare Financial Management Association (HFMA) and featured Panacea financial executives, Fred Stodolak, Executive Vice President and Mark Spehar, Senior VP Financial Services as presenters.

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On Demand Webinar: Debunking the Myth: Why Charges Still Matter in the Age of Pricing Transparency

The push for health care price transparency is nothing new and can be traced back almost 20 years. When CMS released their proposed 2019 Inpatient Prospective Payment System (IPPS) rules including “requirements for hospitals to make public, a list of their standard charges via the internet”, it further underscored CMS’ continued effort for hospitals and health systems to provide price transparency.

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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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It’s a Fact: Revenue Integrity Programs Increase Net Revenue

Is your revenue integrity program performing at full capacity?

Perhaps more important, do you have a revenue integrity program (or department) at all?

A survey conducted by the Healthcare Financial Management Association (HFMA) reports that less than half (44%) of providers contacted have a revenue integrity department to track accurate coding and charge capture, establish reasonable pricing for services, ensure legal and regulatory compliance, and develop effective financial reporting. Yet those that have established revenue integrity programs have realized an overall increase in net revenue.

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Does your organization have a strategic plan to address CMS FY19 IPPS proposed rule that requires hospitals “to make public their standard charges via the Internet?”

Written By: Fred Stodolak, Executive Vice President, Mark Spehar, Senior Vice President, Financial Services, Henry Gutierrez, Vice President, Financial Services

There is an increasing debate surrounding CMS FY2019 IPPS proposed rule, published April 24, that would require hospitals “to make public a list of their standard charges via the internet.” Discussions around this topic have pointed out a number of valid arguments:

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University of Utah Health: Making the Case for Auditing CDI Queries

The University of Utah has taken a unique approach to CDI. They have determined that standards and auditing are critical components of the CDI process. But how does a facility begin auditing queries? And what constitutes a compliant query?

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Cultivating Homegrown Inpatient Auditors

By training coders who already are on staff, hospitals leverage institutional knowledge and build career paths.

Changes in payment policies, laws, and regulatory oversight are forcing healthcare organizations to respond to increased regulatory scrutiny and audits. Medicare audits have increased by 936 percent in the past five years*. Ad hoc inpatient audits are no longer enough of a defensive strategy. Robust internal auditing programs are becoming a must for inpatient organizations.

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Key Learnings from HCCA 2018 Compliance Institute Conference.

We had a great time at HCCA’s Compliance Institute conference in Las Vegas and enjoyed meeting everyone.  It’s always so exciting to see all of the strategies and methods professionals across the healthcare industry are using to accomplish their diverse goals.

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IR Coding: 100% Bundled, Component Coded or Hybrid-Bundled

In 1992, CPT coding options for interventional radiology (IR) procedures underwent a seismic shift in “how” to code. Gone was the old method of complete procedure codes (a one-size-fits-all code); the new method added separate options to describe “what was done” and “where or how you did it.”

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Renown University: How One Organization Cultivated Their Own Coding Team and Saved 2.27 Million

Like many other organizations, Renown faced significant challenges finding experienced coders. In 2014, they decided to develop their own coding team and started their own coding educational program called Renown University.

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