Since the October 1, 2015 commencement of I-10, both case mix index trends and CC/MCC capture rates nationwide have improved by 2.8% and 0.8% respectively.Years of coding and documentation training to address the tenfold increase in available codes and the need for improved specificity and documentation under I-10 appears to be paying off overall.
https://insights.panaceainc.com/wp-content/uploads/2018/12/Insights-featured-image.jpg156233Panacea Insightshttps://insights.panaceainc.com/wp-content/uploads/2020/02/logo-panacea-besler.pngPanacea Insights2018-12-12 13:33:112020-06-28 10:45:43National CC/MCC Capture Rate and Case Mix Index Study. A nationwide analysis of hospitals’ case mix index trends and CC/MCC capture rates since the implementation of ICD-10.
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.
https://insights.panaceainc.com/wp-content/uploads/2018/12/HFMA-Webinar.jpg156233Panacea Insightshttps://insights.panaceainc.com/wp-content/uploads/2020/02/logo-panacea-besler.pngPanacea Insights2018-12-04 12:26:072020-08-03 14:48:03Developing a Pricing Strategy for the 2019 CMS Transparency Requirement
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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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.
https://insights.panaceainc.com/wp-content/uploads/2018/07/financial-report-chart-and-calculator-medical-report-and-stethoscope-picture-id818256904-2.jpg156233Panacea Insightshttps://insights.panaceainc.com/wp-content/uploads/2020/02/logo-panacea-besler.pngPanacea Insights2018-07-17 13:45:432019-01-18 08:36:00Case Study: Achieve Significant Efficiencies through a Comprehensive Audit Program to Ensure Compliant Coding and Optimal Reimbursement
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.
https://insights.panaceainc.com/wp-content/uploads/2018/07/young-finance-market-analyst-in-eyeglasses-working-at-sunny-office-on-picture-id815165952-2.jpg156233Panacea Insightshttps://insights.panaceainc.com/wp-content/uploads/2020/02/logo-panacea-besler.pngPanacea Insights2018-07-11 12:16:382019-06-06 12:20:51It’s a Fact: Revenue Integrity Programs Increase Net Revenue
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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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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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.
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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