Over the last several months we’ve seen an uptick in requests from clients nationwide for help reconciling laboratory orderables to chargemasters. In case you’re in this same boat, we wanted to provide some insight into the steps you should be taking.
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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? Panacea’s CEO, Frederick Stodolak, provides his recommendations on where to start.
Beginning July 1, Medicare will require prior authorization for five procedure classes: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation. As a reminder, prior authorization was announced through the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (CMS-1717-FC).
Panacea has summarized the Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) payment and coding updates, effective July 2020 (with some retroactive changes). Please review the updates for possible implementation in your hospital chargemaster and/or review by applicable department, coding and billing staff.
Compliance plans are critical to making sure your organization is mitigating risk. The Office of Inspector General (OIG) recommends that you audit a minimum of 10 professional encounters per year per physician—but if you’re not going above and beyond that by performing focused audits, you’re putting your practice at risk by ignoring everything else. Not […]
The radiology department is typically one of the biggest within a healthcare facility, and the Radiology Information System (RIS) is a critical component of this department. Facilities rely on these systems to manage imaging protocols by modality as well as charging for services and orderables. Therefore, if your RIS contains incorrect or outdated data, you […]
Please join us on Thursday, June 4, 2020, at 1 pm ET, for our 90-minute live webinar, “How to Avoid the 5 Pitfalls In Coding Nuclear Medicine, Diagnostic Radiology, and Interventional Services.” The webinar will focus on learning how to avoid coding and compliance risks and how to capture all charges for Nuclear Medicine and […]
Effective January 1, 2019, CMS required that a hospital publish their chargemaster online for consumers. At the time it was made clear by CMS that this would be the first of potentially many initiatives geared toward increasing transparency around hospital and other provider fees. The goal of all of these changes is to improve the […]
With the CMS Final Rule published there is a flurry of activity across the industry to come up to speed on the changes. In our experience though we’ve found that for many healthcare systems it’s easier to keep track of changes to the codes, rules, and guidelines they are already using; the challenge comes in becoming aware of and implementing when new things are introduced.