Revenue Integrity

The Enterprise Charge Management Solution for Healthcare Organizations

ChargeAssist^® CDM Management Tool

The ChargeAssist^® software tool is a robust online charge management solution used by hospitals, healthcare systems, and leading Chargemaster and Revenue Cycle Management experts. Learn more →

Comprehensive CDM Reviews

Chargemaster (CDM) reviews are a crucial component of maintaining financial health within healthcare organizations. By conducting these detailed assessments, we can uncover and rectify discrepancies in billing and coding, ensuring compliance with Medicare regulations and optimizing revenue streams. Learn more →

Revenue Defender™

Revenue Defender™ is a pivotal solution designed to bolster revenue integrity across healthcare organizations. By focusing on four critical pillars— compliance, charge capture, accurate reimbursements, and protecting rightful revenue—this solution lays the foundation for robust revenue cycle management. Learn more →

CLAIMSauditor^®

CLAIMSauditor^® is the fastest and most flexible cloud-based technology that allows compliance teams and other healthcare professionals to find coding, compliance and financial risks and opportunities hidden in their provider claims and other detail data. Request Demo →

PHARMauditor™

PHARMauditor™ is Panacea’s cloud-based software tool, can be used to maintain accurate pharmacy coding, compliance and reimbursement. Request Demo →

Comprehensive CDM Reviews

Our Comprehensive CDM review focuses on the chargemaster as the fuel of your revenue cycle engine and examines a number of priorities, including:

Identifying charging vulnerabilities
Eliminating coding and billing errors
Generating correct revenue
Sustaining regulatory compliance

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Charge Capture Review

Panacea gives you a leg up in evaluating your revenue integrity by leveraging technology and expertise to assess your charge capture processes and accuracy.

We track a charge all the way from the medical record to the detailed bill to the final submitted claim to the remittance advice. Your claims data will be processed through hundreds of lost revenue and charge rules to flag potential issues and opportunities. We can review all of the departments in your organization or only those of specific concern.

This in-depth review identifies opportunities for charge capture, and we also provide education for your clinical departments on the charge process to ensure understanding and compliance. We can also include interviews with key team members to identify if all hospital services—including technical fees (facility charge), and professional fees (provider charge)—are accounted for.

Key Benefits:

Identify lost charge areas
Process improvement
Flag EHR or billing systems issues
Understand documentation integrity opportunities
Determines areas of focus for education

Managed Care Report Card

The Managed Care Report Card is a tool that provides an independent, third-party evaluation of your managed care payers to confirm that you are receiving expected reimbursement.

The Report Card will help answer important questions regarding your managed care reimbursement:

Are similar cases being paid in a consistent manner across payers?
Are carve-outs being paid appropriately?
Are there excessive denials?
Are there unnecessary delays holding up your reimbursement?
Are your payment levels similar to like providers?

Through a simple data download (common 835/837 files) we analyze your managed care reimbursement activity. The Report Card reviews multiple payers and compares your organization’s billed and paid managed care claims to best practice standards. After the results have been analyzed, we provide a scorecard of your facility’s performance with an explanation of our findings, which also includes areas suggested for further analysis.

The Managed Care Report Card provides the ability to evaluate the health of your managed care reimbursement without having to configure and reconcile a contract management system. It validates your efforts in collecting entitled managed care revenue and identifies areas where your organization can improve. The Report Card can confirm your organization’s success and also can act as a catalyst to help make meaningful change for your managed care reimbursement processes.

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