Be proactive, use CDMAuditor.com to:

• Upload your CDM information to this site from anywhere, anytime
• Receive data quality support at no additional cost
• Login to access, view & print a complete set of CDMAuditor reports

These timely reports include:

• Invalid CPT/HCPCS Codes
• Invalid REVENUE Codes
• Description Changes
• Price inconsistencies for multiple uses of HCPCS codes
• Missing devices Missing codes
• Prices below wage adjusted APC payment
• Zero volume items by service code
• And much more..

Clearly the most defensible price is one that is based on actual cost. Over the decades with many hospitals being reimbursed or paid less than cost by Federal and Managed Care payers, shortfalls were subsidized through selective price adjustments or cross-subsidization. After years of deploying such techniques, hospital administrators are found today in an era of intense public price scrutiny with chargemasters incredibly difficult to explain.

Developed by leading authorities at Panacea Healthcare Solutions, the Hospital Zero-Base Pricing™ program can get your prices back to square one. You will rest assure that your price is not only sufficient to maintain your net revenue objectives but that its foundation is based on cost. Some firms will re-align your prices to conform to the market while maintaining or increasing net revenue levels. With Hospital Zero-Base Pricing™ prices are established based on estimated or actual unit cost while maintaining or increasing net revenue levels. That's not to say market prices, APC rates or Fee Schedules are ignored. Before finalizing price models some prices will inevitably be adjusted to ensure that the cost based prices don't fall below contractual amounts and that others remain competitive. There's more... you will receive net revenue models for multiple pricing scenarios and an excellent audit trail for each line item for future reference when defending your prices. You can even perform your own modeling using our secure web-based system.

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With Panacea Healthcare Solutions CDMSync™ system  you can upload the charge description master (CDM) for each entity within your health system and CDMSync.com will analyze the data to flag inconsistent service codes, descriptions, HCPCS codes, REV codes, and Prices for like services and/or line items.  The system does this utilizing a proprietary process conceived and developed by PHS.  After inconsistencies are flagged the user is prompted to accept, reject or change the systems proposed alternative choices.  Once the user is complete, an electronic upload file is created for the hospital to implement the changes therefore reducing the risk of data entry errors and to achieve a fully “Synchronized” CDM health system wide.

PHARMAlookup ™

This web-based tool, provided in partnership with MedLearn, will allow you to update your NDC’s with HCPCS/Codes on a single drug look up at a time.
The value of this tool includes:

• NDC-to-HCPCS/CPT drug code crosswalks encompassing over 23,000 products
  
  
• Access to all HCPCS and CPT drug codes, with corresponding descriptions, as established by the CMS and AMA
  
  
• A wealth of data, such as new and revised drug codes for the current year; codes deleted since 2000, along with references to replacement codes, if established; and drugs billable under a NOC (not otherwise classified) code
  
  
• What’s more, you enjoy the flexibility of searching MedLearnDrugCodes.com by drug name (brand or generic), HCPCS or CPT code, NDC number, ICD-9-CM code or therapeutic class.

PHARMAcrosswalk™ 

NDC Update with HCPCS/CPT Codes

Upload your NDC file spreadsheet, once or routinely, via our web-site, with or without, HCPCS/CPT codes and you will receive a complete report that flags outdated or invalid NDC codes and descriptions and provides most current associated HCPCS/CPT codes and updated information.

PHARMAauditor ™

Upload your Pharmacy CDM and NDC file with service codes, descriptions, cost, and more and our system will automatically perform a comprehensive assessment and provide you with the information you need to ensure accurate and correct for revenue codes, HCPCS/CPT codes, billing units, NDC (National Drug Codes) and AWP (Average Wholesale Pricing).  You will now have the information you need to maintain a correct and compliant Pharmacy Chargemaster.  Our partners at MedLearn are always available to assist you in interpreting the results, implementing the changes and to work with your hospital IT department to migrate the pharmacy data file (additions, changes, deletions) directly into your pharmacy chargemaster.

Comprehensive Pharmacy Department Charge Capture & Billing Review & Analysis

Pharmacy Chargemaster Update with Claims Analysis

We understand the importance of pharmacy to a hospital's bottom line and how critical it is to have the hospital billing system accepting and recording information correctly from the pharmacy system.

Client Benefits
- Appropriately capture pharmacy revenue
- No missed charges
- Create a process for a sustainable business model for pharmacy

Our Approach and Objectives

Our pharmacy operations analysis includes reviewing the entire process from receipt of physician order to posting of proper payment. Our approach encompasses a documentation review and a comprehensive analysis of charge capture processes and CDM validation using the NDC database.  Starting with the physician order, our consultants follow the encounter from the pharmacy's dispensing of the drug to the point of administration where the focus is ensuring accurate charge capture, claims processing and receipt of accurate payment. It is critical to not miss charges or under or over record billing units.

If you would like more information or a proposal on any of these timely services please contact Jim Russell, Senior Vice President, Accounts Receivables and Revenue Cycle Management at Panacea Healthcare Solutions at jrussell@panaceahealthsolutons.com or 866-926-5933 extension 705.

Coding Tool Features:

• Search across multiple code sets by code, description or key terms for instant outpatient and physician payment rates and coding guidance including local coverage determinations and critical coding guidance.
  
  
• Additional code tools include: NCCI Code Edit tool and Drug Lookup tool.
  
  
• E-Codebooks integrate with the Explorer tool to allow you to significantly reduce your coding orders and subscriptions.
  
  
• E-Codebooks provide complete code set content for HCPCS, CPT®, APC, ICD-9-CM, Physician Fee Schedule, MS-DRG, NCCI, PQRI Cross Coding, and NDC-HCPCS & DMECS brand-name drug crosswalk.

Coding Guidance Resources:

• A medical dictionary, select CMS Manuals, CPT® Assistant, CPT® Changes, and Medicare coding and billing guides further expands the list of reference material you can access before a code is assigned.

• Payment system final rule e-books including: inpatient PPS, outpatient PPS, physician fee schedule and ambulatory surgical centers. 

• Customizable daily and weekly alerts, stored search alerts and personal bookmark folders have WK working for you when you tell us what you want to see and when you want to see it.

Compliance Resources:

• CMS Transmittals, MLN Matters, CMS Frequently Asked Questions, Medicare National Coverage Manual, and Job Aids are updated daily to keep you apprised of real-time coding changes and discussions as they are released in one easily accessible place.

Medical Necessity Resources:

• Quick and easy access to LCDs, NCDs, RACs, and contractor bulletins provide effective validation of the medical necessity of ordered outpatient procedures and services.
  
  
• User can choose by contractor: MACs, Carriers and Intermediaries for specific local guidance.  

Fee and Payment Tools:

• Easily reference the adjusted Medicare reimbursement rate for your region via the MediRegs® quick calculators for APC, RVU and MS-DRG.
  
  
• Link to CCH® Coding Comply to obtain a code set history and related documents.