On August 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that was intended to empower patients through better access to hospital price information. Current laws already required hospitals to make public a list of their standard charges, but the new requirement which became effective on January 1, 2019, required hospitals to publish a list of all charges in machine readable format via the internet, in an XML or CSV format. The final rule also required providers to update their posted charges no less than one time per year.
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https://insights.panaceainc.com/wp-content/uploads/2019/05/whats-next-picture-id483661187.jpg300566Panacea Insightshttps://insights.panaceainc.com/wp-content/uploads/2020/02/logo-panacea-besler.pngPanacea Insights2019-08-20 09:42:182020-08-03 14:49:48Pricing Transparency is Here. What Now? What next?
Learn a new holistic approach to physician auditing using technology, expertise, and education. With a predictive analyzer tool, you can identify incidents and patterns of potential billing and coding as well as opportunities where under-coding of services may be taking place. The results will drive meaningful focused audits and provider specific education.
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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.
To view this content you need to subscribe to Panacea Insights. You'll get updates on new posts, become a influencer in our community and get invited to special webinars.
https://insights.panaceainc.com/wp-content/uploads/2019/06/compliance-audit-and-documents-on-a-desk-picture-id964199966.jpg400566Panacea Insightshttps://insights.panaceainc.com/wp-content/uploads/2020/02/logo-panacea-besler.pngPanacea Insights2019-06-13 11:28:402021-01-27 23:51:15The Top 3 Compliance and Auditing Mistakes and How to Avoid Them
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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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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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:
To view this content you need to subscribe to Panacea Insights. You'll get updates on new posts, become a influencer in our community and get invited to special webinars.
https://insights.panaceainc.com/wp-content/uploads/2018/06/PricingTransparencyiStock-491205902.jpg402604Panacea Insightshttps://insights.panaceainc.com/wp-content/uploads/2020/02/logo-panacea-besler.pngPanacea Insights2018-06-14 09:23:392020-08-03 14:46:56Does 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?”
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 of a defensive strategy. Robust internal auditing programs are becoming a must for inpatient organizations.
To view this content you need to subscribe to Panacea Insights. You'll get updates on new posts, become a influencer in our community and get invited to special webinars.
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.
To view this content you need to subscribe to Panacea Insights. You'll get updates on new posts, become a influencer in our community and get invited to special webinars.
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.”
To view this content you need to subscribe to Panacea Insights. You'll get updates on new posts, become a influencer in our community and get invited to special webinars.
Pricing Transparency is Here. What Now? What next?
/in Expert Opinions, Price Transparency /by Panacea InsightsOn August 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that was intended to empower patients through better access to hospital price information. Current laws already required hospitals to make public a list of their standard charges, but the new requirement which became effective on January 1, 2019, required hospitals to publish a list of all charges in machine readable format via the internet, in an XML or CSV format. The final rule also required providers to update their posted charges no less than one time per year.
Driving Focused Physician Audits and Education Using Predictive Analytics
/in Expert Opinions /by Panacea InsightsLearn a new holistic approach to physician auditing using technology, expertise, and education. With a predictive analyzer tool, you can identify incidents and patterns of potential billing and coding as well as opportunities where under-coding of services may be taking place. The results will drive meaningful focused audits and provider specific education.
The Top 3 Compliance and Auditing Mistakes and How to Avoid Them
/in Expert Opinions /by Panacea InsightsIn 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.
CMS Price Transparency Requirement: Six Steps Towards Ensuring Compliance and Defensible & Rational Pricing
/in Expert Opinions, Price Transparency /by Panacea InsightsThe 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
/in Expert Opinions /by Panacea InsightsIs 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.
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?”
/in Expert Opinions, Price Transparency /by Panacea InsightsWritten 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:
Cultivating Homegrown Inpatient Auditors
/in Expert Opinions /by Panacea InsightsBy 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 of a defensive strategy. Robust internal auditing programs are becoming a must for inpatient organizations.
Key Learnings from HCCA 2018 Compliance Institute Conference.
/in Expert Opinions /by Panacea InsightsWe 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 Expert Opinions /by Panacea InsightsIn 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
/in Expert Opinions /by Panacea Insights