Chargemaster Coding, Compliance & Strategic Pricing
CDMauditor.com is the nation’s most comprehensive, innovative and affordable suite of distinct cloud-based modules to maintain and improve your charge description master (“CDM”) and pharmacy formulary coding, compliance, strategic pricing and reimbursement. CDMauditor also helps health systems maintain consistency across entities. The CDM Auditor suite is comprised of the following synergistic modules:
Coding and Compliance Module
Maintain your Chargemaster with CDMcompliance.com. The CDM Auditor Coding & Compliance module is used by hospitals and consultants to assess update and maintain the coding, compliance and reimbursement accuracy of the charge description master (“CDM”) in an environment of ever-changing coding, compliance and reimbursement regulations under Medicare, Medicaid and requirements by Managed Care Payors. You’ll receive email alerts, ongoing support by Panacea chargemaster consulting experts, and access to an extensive coding, compliance and reimbursement library including all pertinent regulatory updates, transmittals and more through our integration with MediRegs Coding & Revenue Center.
Hospital Zero-Base Pricing® Module
Develop defensible and optimum chargemaster pricing with strategic pricing. This state-of-the-art program used by hospitals nationwide establishes prices based on unit costs, market data or a hybrid thereof. Sophisticated software and support by Panacea pricing experts ensures that Hospital Zero-Base Pricing® will allow your hospital to implement and maintain optimum and rational prices year after year.
You will receive an impressive set of online and printed reports illustrating the gross and net revenue impact by department, patient type, and payor along with an executive summary dashboard and of course a line by line audit trail documenting how each charge was developed. Perform unlimited modeling and “what-if” scenarios with our secure cloud-based system. Those hospitals not having a cost accounting system can base prices on market and other benchmark data or take advantage of our practical unit cost estimator system and service to expeditiously and economically develop estimated unit costs for all chargemaster line.
Comparative Hospital Data Module
Analyze peer pricing and utilization data with Panacea’s Comparative Hospital Data™ system. Panacea has developed the nation’s first, easy-to-use and cost efficient solution for hospitals or consultants to develop unlimited customized peer comparison groups based on a claims and cost report representing more than 5,000 hospitals.
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With the Comparative Hospital Data™ system you will be able to compare:
- Hospital unit costs and prices to any single or group of hospitals nationwide
- Room & board rates and prices at the HCPCS/CPT level
- Charge-to-cost mark-up factors for operating room, medical supplies, drugs and more
- Coding & pricing patterns
- Outpatient HCPCS coding differences between you and your peers
Print reports to the screen or export to Excel. Create and share files with other Panacea modules. For example, if you create one or more customized peer groups utilizing our Comparative Hospital Data system you will also be able to establish new prices using our Hospital Zero-Base Pricing® module incorporating your new customized peer group without even having to upload the peer group files.
Unit Cost Estimator Module
Panacea’s CDMauditor.com Unit Cost Estimator module, used in conjunction with the full support of our expert financial consulting team, can be used to expediently and economically develop direct and fully allocated unit cost estimates for each CDM line item. This information can be used to develop cost based prices or hybrid (market and cost) based prices without the financial and manpower burden of implementing a full blown cost accounting sytem. The resultant unit cost estimates can also be used to replace less sophisticated ratio of cost-to-charge (RCC) costing methods that may be used in decision support systems thus improving your profitability analytics.
Ensure your pharmacy chargemaster is correct and compliant with PHARMauditor.com™. Wondering whether you are appropriately capturing your pharmacy revenue? Know for sure with PHARMauditor.com. This web-based tool performs a comprehensive review to ensure accurate and correct revenue codes, HCPCS/CPT codes, billing units, national drug codes (NDCs), descriptions and average wholesale pricing. The system automatically:
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- Appropriately captures pharmacy revenue
- Achieves precise mapping between Pharmacy System and CDM
- Ensures that HCPCS and Revenue codes are assigned for all NDCs
- Ensures correct descriptions and dosages are reflected in CDM and Formulary
- Maintains current and valid NDC numbers
- Ensures accurate billable units, package size and package quantity for NDC
- Evaluates current price relative to AWC and WAC cost times regional or other mark-up and APC rates
- Reduces your RAC risk
- Quickly searches by drug name (brand or generic), HCPCS or CPT code, NDC number, ICD-9-CM code or Therapeutic Class
Synchronize Disparate Health System Chargemasters with CDMsync™ Often, as a result of acquisitions or mergers, health systems find their organizations in the awkward predicament of charging dramatically different prices and using inconsistent codes and descriptions for like services among their entities. This not only creates public relations issues but also makes it difficult to manage and provide vital reports from their decision support systems. A typical engagement for CDMsync™ involves uploading the disparate CDM’s where the system will proceed to match like items or group seemingly like items from which a Panacea consultant or someone on your team will then utilize an innovative drag and drop feature to finalize and create a master CDM across the health system entities. The system will automatically propose the most predominately used codes and calculate weighted average prices for users to utilize in making their final determination.