Auditing and Compliance Services

Payer strategies are evolving quickly. Are you prepared?

Auditing and compliance that reduces risk and creates opportunity.

Panacea’s proven auditing and compliance approach is created around your needs. We help you reduce risk, strengthen coding and documentation, and keep your compliance goals on track.

Our nationally recognized consultants specialize in inpatient, outpatient, physician professional fee, and behavioral health services. We take a comprehensive approach which includes can interventional radiology, cardiology, most surgical specialties, and oncology.

All our services include an executive summary report along with details that include specific examples and recommendations for corrective action measures. In addition, we deliver clear, actionable directions for meeting complex state and payer specifications.

Inpatient

Panacea helps you meet inpatient auditing and compliance goals, reduce risk, and ensure accurate coding for better reimbursement.

We use proven methods to identify improvement areas during audits and compliance reviews, then tailor our approach to your organization’s needs. Our inpatient services include DRG validation, medical necessity reviews, clinical validation reviews, and managed care contract compliance.

We help keep your documentation, coding, and billing aligned with federal, state, and payer guidelines while reducing compliance risk.

Outpatient

Panacea’s focused outpatient audits target the areas of greatest risk, combining deep expertise with technology to deliver precise, efficient reviews.

Our services include E/M and CPT documentation and coding reviews across outpatient settings, including complex services, infusions, interventional radiology, cardiac catheterization labs, laboratory compliance assessments, surgical procedures, anesthesia, and OIG focus areas.

Our goal is to keep your documentation, coding, and billing aligned with federal, state, and payer guidelines while helping you secure appropriate reimbursement and maintain compliance.

Physician

Panacea’s approach to practitioner audits leverages our proprietary technology, predictive analytics, and the expertise of our auditing team to help you apply the right tools for your organization.

Our goal is to help you identify incidents and patterns of potential billing and coding risk, as well as opportunities where under-coding may be occurring. We’ll help you achieve complete confidence in meeting your compliance goals and maximizing coding accuracy.

Behavioral Health

Panacea partners with behavioral health organizations to manage risk, strengthen documentation, and stay current with evolving federal, state, and payer requirements.

Our audits align with current regulations and cover in-person care, telehealth, and the Collaborative Care Model (CoCM). We review documentation accuracy, medical necessity, coding integrity, and payer compliance to reduce risk, avoid denials, and support defensible billing.

We also offer targeted audits that evaluate documentation by modality, consent requirements, time tracking, platform compliance, and coding accuracy.

Our goal is to help you expand services with confidence while minimizing compliance risk.

“Panacea’s auditing and compliance solutions have been instrumental in helping us navigate the ever-changing regulatory landscape. Their tech-enable tools and services provide unparalleled accuracy and insights. With Panacea’s expertise, we’ve strengthened our processes and maintained confidence in our compliance efforts.” —VP Revenue Cycle