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Coronavirus Outbreak – Institutional (Facility) Coding and Billing for Telehealth Services

Panacea is providing guidance for institutional (facility) billing during this public health emergency. Hospitals will need to take additional steps to ensure coding and billing are appropriate during this time. For the most part, billing for telehealth services has not changed with exception of the information provided below. HCPCS code Q3014 (Telehealth facility fee) describes […]

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Coronavirus Outbreak – Provider Telehealth Coding and Billing

In an effort to provide coding and billing assistance to Panacea’s clients and the provider community during this public health emergency, we have developed some general Telehealth coding and billing guidance and listing of eligible codes not only permitted for use by Medicare and Medicaid but at least two major payers (UnitedHealthcare and Blue Cross […]

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UPDATE: CMS and AMA payment and coding guidance for COVID-19

Panacea has summarized the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) payment and coding updates being implemented during this public health emergency into the following sections:

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Coding and Reimbursement Highlights for 2020 IPPS, MPFS & OPPS

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.

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Unpacking CMS’ 2020 Proposed Expanded Rules for Hospital Price Transparency

On January 1, 2019 the Hospital Price Transparency Rule took effect mandating hospitals publish their price lists online in a machine-readable format. Hospitals complied by making their charge description master (CDM) available via download in CSV or similar format. The result fell far short of CMS’ goal of empowering patients to become “active healthcare consumers” and the agency on July 29, 2019, in response to the Trump administration Executive Order on Price and Quality Transparency, proposed expanded rules aimed at more “consumer friendly” transparency.

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Summary of the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) payment and coding updates for Q4′ 2019

We’ve summarized the Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) payment and coding updates being implemented October 1, 2019. The updates should be reviewed for possible implementation in your hospital chargemaster and/or reviewed by applicable coding and billing staff.

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Is Your Staff Struggling with How to Bill Lab Services? 4 Steps to Better Results

As laboratory services are one of the highest revenue-producing departments in most health systems, it’s incredibly important to bill these services correctly. However, it’s also an area fraught with lots of guidelines and restrictions—and with many staff members throughout the hospital system working laboratory accounts, there is a high risk of errors and inconsistencies. This is a situation we’ve seen and helped correct in health systems nationwide.

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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 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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Panacea Announces Enhanced Pharmacy Revenue Improvement Solution

Panacea announces enhanced Pharmacy Revenue Improvement solution, which combines expert consultants…

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Mergers + Acquisitions: Is Your Chargemaster Strategy Sound?

Expansion — through mergers, acquisitions, joint ventures and other strategic partnerships — has become an important tool in a hospital’s strategic wheelhouse. As your footprint expands to encompass the entire continuum of care, how do you ensure your chargemaster strategy is sound and consistent?

We break this question into two parts — soundness and consistency — for good reasons:

First, in an era of increased public price scrutiny, hospital CFOs must ensure that their chargemasters are defensible and can be clearly explained to outside observers and auditors.

Second, mergers, acquisitions and other affiliations often bring under a single umbrella organizations that may have very different pricing and coding methodologies, practices and strategies.

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