Auditing and Compliance Services

Payer strategies are evolving quickly. Are you prepared?

Auditing and compliance that reduces risk and creates opportunity.

Panacea’s unique approach to auditing is tailored to focus on driving down risk, improving coding and documentation, and meeting your auditing and compliance goals.

Our nationally recognized consultants have expertise in Inpatient, Outpatient, and Professional Fee (Physician) services, including specialties such as Interventional Radiology, Cardiology, most Surgical specialties, Oncology, Evaluation and Management, and many more.

Inpatient Auditing

Panacea’s experts help meet your inpatient auditing and compliance goals, identify and minimize risk areas, and ensure accurate code assignment for improved reimbursement.

When performing an inpatient audit, our expert consultants conduct a comprehensive review that prioritizes evaluating your team’s skills in target coding areas, analyzing the completeness of documentation and appropriateness of physician queries, and ensuring correct code transfer to claim forms and proper MS-DRG payment received on the remittance advice.

Outpatient Auditing

Panacea applies the same proven, unique approach to outpatient reviews as we use on the inpatient side, focusing on surgery, infusion and chemotherapy, as well as emergency department and other ancillary services.

Our expert consultants work closely with you to determine the correct methodology for your organization, conducting a comprehensive review that will evaluate your team’s skills in ICD-10-CM and CPT®, analyze your claims information to target specific areas for focused audits, and ensure correct code transfer to the claim forms and proper APC payment received on the remittance advice.

Physician Auditing

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.

Specialty Auditing

As you manage your organization’s auditing and compliance efforts, it is important to make sure you include complex areas such as infusions, interventional radiological (IR), cardiac cath lab, laboratory compliance program assessment, surgical procedures, anesthesia, E/M, and OIG targets.

Panacea’s expert consultants are specialists in these areas, and we can boost your team’s skills to improve quality and accuracy.

Key Benefits:

Ensure your team understands the latest coding changes
Appropriately capture revenue
Reduce errors that result in rejections
Identify missing charges

“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