Entries by Panacea Insights

Whitepaper: Combating Denials and DRG Downgrading

Payer strategies are evolving quickly, and healthcare organizations must be alert to make the most of revenue opportunities while mitigating claims denials. In light of recent denials and DRG downgrading by payers, how your organization adapts will profoundly affect your reimbursements. An organization’s own internal review can set the stage for monitoring and remediating any inappropriate downgrading of DRGs by the payer.

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Mergers + Acquisitions: Is Your Chargemaster Strategy Sound?

Expansion — through mergers, acquisitions, joint ventures and other strategic partnerships — has become an important tool in a hospital’s strategic wheelhouse. As your footprint expands to encompass the entire continuum of care, how do you ensure your chargemaster strategy is sound and consistent?

We break this question into two parts — soundness and consistency — for good reasons:

First, in an era of increased public price scrutiny, hospital CFOs must ensure that their chargemasters are defensible and can be clearly explained to outside observers and auditors.

Second, mergers, acquisitions and other affiliations often bring under a single umbrella organizations that may have very different pricing and coding methodologies, practices and strategies.

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Payer Denials: Can You Win on this New Battleground?

In today’s complex health care environment, in which CMS and insurers each maintain their own claims-related “rules,” disputes, DRG downgrades and denials are all-too common.

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Webinar: Effective Chargemaster Management As The First Line of Defense for Revenue Integrity

Charge data and coding accuracy is more important than ever—but the challenges facing healthcare organizations have also grown exponentially. Help your organization stay ahead of the chargemaster curve with our complimentary one-hour webcast.

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Webinar: How to Combat Denials and Avoid DRG Downgrades

Are you are seeing rising claim rejections in your practice? Maybe you’re experiencing a slowing of reimbursement and consequential reduction in revenue since ICD-10. Learn how coding accuracy can reduce these denials and improve your results.

To view this content you need to subscribe to Panacea Insights. You'll get updates on new posts, become a influencer in our community and get invited to special webinars.