Entries by Panacea Insights

National 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. 

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

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CMS Price Transparency Requirement: Six Steps Towards Ensuring Compliance and Defensible & Rational Pricing

The CMS 2019 transparency requirement underscores their ongoing initiative and emphasis on empowering patients through better access to hospital charge information.

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Webinar: 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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News: Panacea Responds to CMS Final Rule Effective October 1, 2018 Requiring Hospitals to Publish their Chargemaster via the Internet

Hospitals have just a few months to ensure their prices are rational and defensible to meet the January 1, 2019 deadline. St. Paul, MN—August, 2018—Panacea, a leading provider of mid-revenue cycle management, innovative software and enterprise-level educational solutions announced today that despite industry push-back during the comment period, the CMS Final Rule requires hospitals to […]

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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HFMA Awards Panacea “Peer Reviewed” Designation for 2018

May 23, 2018—Panacea, a Career Step company and leading provider of revenue cycle management, smart software and enterprise-level educational solutions, is pleased to announce that after a rigorous review, the Healthcare Financial Management Association (HFMA) has awarded Panacea’s CDMauditor® Hospital Zero-Base Pricing® its “Peer Reviewed by HFMA” designation. Panacea’s Comparative Hospital Data™, Unit Cost Estimator, […]