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. 

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.

CMS Price Transparency Requirement: 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.

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 […]

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 […]

Cultivating Homegrown Inpatient Auditors

By training coders who already are on staff, hospitals leverage institutional knowledge and build career paths. Changes in payment policies, laws, and regulatory oversight are forcing healthcare organizations to respond to increased regulatory scrutiny and audits. Medicare audits have increased by 936 percent in the past five years*. Ad hoc inpatient audits are no longer enough […]

Key Learnings from HCCA 2018 Compliance Institute Conference.

We had a great time at HCCA’s Compliance Institute conference in Las Vegas and enjoyed meeting everyone.  It’s always so exciting to see all of the strategies and methods professionals across the healthcare industry are using to accomplish their diverse goals.

IR Coding: 100% Bundled, Component Coded or Hybrid-Bundled

In 1992, CPT coding options for interventional radiology (IR) procedures underwent a seismic shift in “how” to code. Gone was the old method of complete procedure codes (a one-size-fits-all code); the new method added separate options to describe “what was done” and “where or how you did it.”

The OIG Targets Herceptin Billing Errors

The OIG has added specialty drug coverage and reimbursement by Medicaid to its Work Plan.

Creating an Internal Inpatient Auditing Program

Changes in reimbursement policies, laws, and regulatory oversight are forcing healthcare organizations to respond to increased regulatory scrutiny and audits.