Feb 14, 2019
Caroline Znaniec, MBA,
MS-HCA, is the founder and principal of Luna Healthcare
Advisors LLC. Her boutique consulting group provides revenue
integrity advisory services to other consultancies and large
advisory firms, software companies and developers, and health
system and physician providers. Caroline writes and speaks
regularly on topics of revenue integrity for many nationally
recognized professional associations, including the Association of
Healthcare Internal Auditors (AHIA), American Health Information
Management Association (AHIMA), Health Care Compliance Association
(HCCA), Healthcare Financial Management Association (HFMA), and
National Association of Healthcare Revenue Integrity (NAHRI). She
has more than 20 years of industry experience, having worked with
the nation’s top health systems and health care talent.
03:12 What a chargemaster is.
04:00 Why chargemaster pricing has become more complex and higher
than any insurance is willing to pay.
05:37 The “self-pay” discount and why this is still
problematic.
06:54 The justification for reducing chargemaster prices.
08:55 The intention behind requiring hospitals to publish their
chargemasters.
10:33 CMS and creating more transparency and competition.
12:12 The conflicting incentives to keep chargemaster prices
high.
14:46 Why this “baby step” is for the payers, not the consumer.
16:55 “The best thing that could happen next … you need to give a
patient-friendly description.”
17:58 “Can you relate your charges to your cost?”
21:40 “Do your charges make reasonable sense?”
22:17 “Do I have varying charges for the same CPT code?”
23:14 “Do your charges reflect the intensity of the procedure?”
24:06 Charging for routine services and defining that.
25:25 “Chargeable items at the end of the day are … helping to
diagnose or treat you.”
25:44 “Are your common items egregiously priced?”
29:26 “You’re not going to engage … your patient in that pricing
transparency … until you get meaningful information out to
them.”