Eight Steps to Reveal Incremental Revenue and Reduce Risk Related to “Lesser-of” and “Stop-Loss” Contract Clauses

Restructuring a hospital’s chargemaster in this era of transparent pricing often results in material increases and decreases in line item charges to align with market norms, unit costs, or a hybrid thereof. Learn how your organization can enhance its financial performance in this environment.

2023 E&M Updates Resources

Wondering how the 2023 updates to E&M guidelines affect your team? Look no further. Our experts have developed a set of customized resources to aid professionals as they put the guidelines into practice.

Evaluation and Management 2023 Updates: What You Need to Know

Changes to 2023 E/M coding will impact CDM files, coding, documentation, charge capture processes, and various information systems. This article outlines new revisions to E/M codes for 2023 and addresses several questions we believe professionals will encounter when they learn of the changes.

How to Rationalize Chargemaster Prices

Have you ever wondered how hospital prices became so irrational? As is often the case, things changed incrementally. Hospitals and healthcare systems have experienced years of inadequate inflationary update factors, often reduced by factors such as presumed over-coding under the federal inpatient and outpatient prospective payment systems.

How to Comply With (and Exceed) the CMS Hospital Price Transparency Rule Requirements

CMS penalties have dramatically increased since the Price Transparency Rule was released, and providers must take heed before CMS and a legislative gauntlet arrive at their front door.

Evaluation and Management (E&M) Split (or Shared) Visits – 2022 Summary of Changes

The 2022 Final Rule defines split (or shared) visits as evaluation and management (E&M) visits in the facility setting that are performed in part by both the physician and a non-physician practitioner (NPP) who are in the same group, in accordance with applicable laws and regulations.

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Document Your Leftovers: The JW Modifier and How to Use It

On Jan. 1, 2017, the Centers for Medicare & Medicaid Services (CMS) and Medicare Administrative Contractors (MACs) began requiring the use of the JW modifier. The JW modifier is appended […]

Pricing Strategies. What’s Your Defense?

In today’s era of intense public scrutiny on medical costs, what’s your pricing strategy? Does it pass the test of fairness and accuracy, without sacrificing revenue objectives? In this article, Panacea’s experts share their recommendations on where to start.

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New Modifiers: Hospital Outpatient Billing for Injectable Self-Administered Drugs

Do you and your team have a good process to readily identify and bill appropriately for self-administered drugs? The Centers for Medicare & Medicaid Services (CMS) has had a longstanding […]

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What’s on Your 2021 OIG Compliance Greatest Hits List?

Compliance plans are critical to making sure your organization is mitigating risk. The U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) recommends that you audit […]