Entries by Panacea Insights

Summary of the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) payment and coding updates.

We’ve summarized the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) payment and coding updates that went into effect on July 1, 2019.   Below is the list of changes and recommendations for possible implementation in the chargemaster, including what your billing and coding staff should know.

The Top 3 Compliance and Auditing Mistakes and How to Avoid Them

In today’s environment of increasing regulatory oversight and ever-changing reimbursement policies, compliance must be more than a checkbox. Though an annual compliance and audit plan is not legally mandated, there are few healthcare organizations that don’t have compliance on their radars. However, if your compliance focus is simply to check a box, you’re missing out.

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Recent survey finds less than half of healthcare providers are ready to publish their standard charges to meet the CMS price transparency requirement

Survey overview:

During a recent webinar on Developing a Pricing Strategy for the 2019 CMS Transparency Requirement, Panacea surveyed 450 healthcare executives to gauge their readiness in meeting the January 1, 2019 CMS Final Transparency Rule deadline. 

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National CC/MCC Capture Rate & Case Mix Index Trend Study

With two-year’s worth of Medicare claims data now available under the ICD-10 coding guidelines, we no longer need to guess about the impact of the new coding and documentation requirements and the industry readiness.

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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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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 […]