Panacea’s CDMauditor® is the nation’s most comprehensive suite of complementary charge description master (CDM) coding, compliance, hospital, physician, and pharmacy strategic and rational pricing, and revenue integrity solutions. You can pick and choose those modules that best meet your needs today and always expand later.
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Hospital Zero-Base Pricing®
Establish & Maintain Defensible Yet Optimum Chargemaster Pricing. Create and run models for each hospital within your health system simultaneously even if where different files and parameters are required. Instantly see gross and net revenue impact results on-screen as you change “what-if” parameters by hospital, by region and in total.
Physician Pricing™ utilizes Physician RVU, Fee Schedule, and Market data to develop rational and defensible Physician prices.
PHARMauditor is used to assess and maintain accurate chargemaster and formulary system coding, compliance and “best practice” drug pricing.
Comparative Health Data
Comparative Health Data is a database containing hospital HCPCS level average charges and volumes, room rates and charge-to-cost ratio’s (e.g. for drugs, supplies, OR, etc.) for 5,000 hospitals and more than 600,000 Physician Medical Offices and Freestanding facilities and allowing clients to develop unlimited market peer groups for use in the Hospital Zero-Base Pricing and Physician Pricing systems.
Unit Cost Estimator
Unit Cost Estimator allows those hospitals wishing to incorporate the unit cost into their rational CDM price development or to replace the ratio-of-cost-to-charge (RCC) method in their profitability reporting systems without incurring the high cost and time frames associated with a traditional cost accounting system. Unit Cost Estimator, combined with Panacea’s consulting team, typically can cost an entire CDM within 90 days and with only eight days of on-site time. The unit cost results are utilized within Hospital Zero-Base Pricing, and the features are accessible through Hospital Zero-Base Pricing for those subscribing to use this feature and service.
CLAIMSauditor®, is a powerful cloud-based system that helps clients identify new incremental revenue opportunities or to proactively identify coding, documentation and compliance risk. Rules found in our library or rules written by your team and be applied to patient level data to find those with the highest probability for revenue opportunity or risk. The system also has an optional audit module which allows for the tracking of inpatient, outpatient and/or physician coding review and accuracy results. It is used under a limited license where the proposed prices are applied to a historical claims database for modeling, if applicable, the net revenue and gross revenue impact of stop-loss provisions and lesser-of-charge versus DRG or per case rates. Finally, an additional limited license option is offered to allow for the modeling of stop-loss and lesser-of-charge versus case rate risk or opportunity associated with proposed chargemaster price changes or to identify managed care underpayments.