The PARA Data Editor (PDE) is a Web application that allows Providers access to a complete solution to audit, correct, enhance code and price your charges.

With one low monthly subscription fee, you receive an unlimited number of Users at your facility and receive access to the following applications within the PARA Data Editor

QUOTE-A-PRICE

PATIENT PRICE QUOTING TOOL

Provide Patients estimated Co-Payments and Out-of-Pocket costs for all Self-Pay and Medicare patients.

• Customized Patient correspondence (letter, fax, or email)
• Check quotation for CCI Edits & Local Coverage Determinations (LCDs) prior to service
• Produce ABNs with quote
• PARA’s proprietary packaging methodology designed to simplify the quoting process and improve accuracy
• Comparative Market Data for cases and line items for up to twelve peer providers
• Group Inpatient quotes by DRG using the 2010 MS-DRG Grouper
• Unlimited Provider defined procedure packages of services
• Additional Payer specific quoting can be added at any time
• Preferred Provider status on the public website www.myMedicalCosts.com improving access to Patients prepaying for services

ADD A CHARGE

CHARGE MAINTENANCE TOOL

Research relevant databases to accurately add new services to the Provider charge schedule.

• Search capability for both billable codes and current charges to eliminate duplicate charges
• Provides recommended codes for all payers
• HCPCS Market Data for up to twelve peer providers to assist with pricing
• Provider specific Medicare reimbursement to assist with pricing
• Surgical Charges are analyzed at the case level and the code line item level
• Drugs & Supplies are automatically priced based on the mark-up policy
• Secure Provider defined email approval chains with tracking for all adds, changes and inactivates.

CONTRACTS

CONTRACT MANAGEMENT AND ANALYSIS

Manage and maintain contract terms for Patient quoting or payer impact analyses

• Track contract terms, demographic, financial, contacts, expiration options
• Contract terms are available for price quoting, using the QAP function
• Terms are incorporated into pricing model
• What if modeling of proposed contract terms
• Payer payment audit capabilities, to identify and recover short payments.

MARKET DATA & REPORTING

ALWAYS ON, ALWAYS ACCESSIBLE, ALWAYS THE MOST CURRENT

Always have access to the latest comparison data in an executive level format

• Claim Data for up to 12 Providers by HCPCS and DRG
• All market reports Include the low, average, midpoint, and high price for each HCPCS code, in addition to the specific price charged by each of the peer market hospitals
• Summary analysis of common Inpatient and Outpatient measures
• Detail analysis includes Hospital specific data, LOS, average charge case mix
• Room Rate - Includes the Room Rate charge of your hospital market peers
• Ad hoc search of market data for any HCPCS at the hospital, county, state or national level

PHARMACY & SUPPLIES

NO MORE QUESTIONS ON WHAT PRICE TO CHARGE

Gain control of your Pharmacy and Material pricing and coding with an easy to use interface

• Make your markup schedule available on-line to price any new supply or drug
• Code any drug using our NDC interface
• Establish markup schedules for general supplies, implants, drugs based on the FDA routes of administration categories, and over the counter drugs and retail supplies

FILTERS

FIND WHAT YOU ARE LOOKING FOR, ASAP

The control tower of your Charge Master/ Price Book allows quick focus on items that need attention

• Three categories of filters – coding, pricing and audit – each improving your revenue cycle
• Coding filters identify the specific items in the CDM that are affected by APC changes, CPT code changes, HCPCS code changes, or any other regulatory impact
• Audit reports are predefined to identify services not currently billed by the Hospital
• Filters identify quarterly APC updates, annual CPT-4 & HCPCS updates, CMS program transmittals, CCI edits, etc.
• Pricing filters will identify items that are below fee schedule, APC, or market targets
• Custom filters to locate items in the CDM

CHARGE DESCRIPTION MASTER / PRICE BOOK

(CDM)

A comprehensive view of all things charge master related

• Edit any charge master CDM code segment, unlimited payers from a single screen
• History of code and price changes, includes who made them, when and why
• Map claim processing edits to the tool to allow a complete view of the bill write system.
• Custom extract file of CDM changes for upload to Hospital system
• 2010 CPT-4 Long & Short Descriptions
• 2010 HCPCS Long Description
• Hospital market comparison data by HCPCS reported at the line level
• Medicare Reimbursement specific to the Provider at the line level
• UB04 National Revenue Code Descriptions
• Medicare CCI Edits (Professional & OPPS)
• Medicare National Coverage Determination Information and Local Medical Review Policies