Meet Your Expert
David Zetter is the founder and President of Zetter HealthCare, LLC in Mechanicsburg, PA and has over 30 years of operational and healthcare experience.
Many recognize David nationally for his presentations and expertise. He excels in revenue cycle management, credentialing and contracting, compliance, coding and documentation. People see David as an expert on Medicare, not only by his clients, but his consultant colleagues across the country. He has evaluated existing ambulatory care facilities and practices with respect to patient flow, operations, use of ancillary services and financial considerations; developing strategic plans to improve profitability and productivity. David Zetter’s activities in management and compliance include physician practices, IDTFs, hospitals, ASCs, pharmacy, DME and other facility types. This includes coding and broad‐based regulatory issues. David has also conducted chart audits on behalf of Medicare contractors and Blue Cross/Blue Shield early in his career. This gave David the knowledge of what the expectations are from the payers.
David’s firm works with healthcare professional clients and facilities coast to coast. Zetter’s specialties include all areas of practice and facility management including start‐ups, buy‐ins, compensation, exit strategies, reimbursement enhancement, practice financial modeling, and governance documentation. Zetter’s firm may also assist you in policies and procedures, credentialing and contracting, HR management, compliance, chart reviews, and more.
David has helped to maximize both profitability and reimbursement of physician practices, facility, and ambulatory practices. He also re‐engineered operational and human resources, addressing coding and billing issues for providers to curtail fraud, OIG, and IRS issues.
Engagements and Associations
He is also an original member of CMS’ PECOS Power User Group, CMS Compliance Focus Group and MIPS Design Lean Work Group. This group provides feedback to Medicare’s Center for Program Integrity and Provider Enrollment Operations Group on design and improvements to the PECOS enrollment environment. It also provides feedback for NPPES and MIPS and beta tests the EHR/HITECH user interfaces. David is also on the CMS contracted team awarded the PECOS 2.0 contract to rebuild PECOS from the ground up.
David has conducted practice management, HR, coding, and compliance education and seminars in many states over the past twenty‐five years. He speaks often on a variety of practice management subjects at hospital residency programs. This includes the NSCHBC, MGMA, AAPC, AHIMA, Florida Institute of Certified Public Accountants, Florida Medical Society, and many other venues. David Zetter works with MGMA, HFMA, Decision Health, Part B News, and Part B Insider to conduct audio conferences and webinars. He is published in Medical Economics and interviewed in publications including Report on Patient Privacy and Report on Medicare Compliance.
David is the current President and Executive Board Member of the National Society of Certified Healthcare Business Consultants. He has served on the Education Committee for more than fifteen years and is a Certified Healthcare Business Consultant. David is a member of the Society for Human Resource Management and former Professional Development Chair/ Vice President of Human Resource Professionals of Central PA. David is a former board member of the Central PA affiliate chapter of the AAPC and is certified as a Professional Coder for physician practices, hospitals and facilities. Additionally, he is also a Certified Compliance Consultant and Officer. Zetter is a member of the AHLA, the MGMA and the HFMA.
Training Sessions by David J. Zetter
CMS specifically prohibits you from using your provider’s PECOS (Provider Enrollment, Chain and Ownership System) login to manage, verify, update or authorize their Medicare enrollments. Instead, the Agency wants you to use their surrogacy system which allows you to work on your provider’s behalf using your own login. Failing to comply with these rules, means that you are NOT in […]Learn More
Payers don’t want you to know how much control you really have regarding your claims’ reimbursement. They don’t want you to know that by applying ERISA regulations, you can force your payers to: pay your claims more quickly, stop downcoding your office visits, overturn claims that were previously denied, expand inadequate appeal deadlines, and return recouped funds previously taken from […]Learn More
When onboarding a new physician into your practice, your process must be flawless. The slightest mistake can result in significant reimbursement delays – or worse, payer rule violations. There are a million details you must get right the first time. Failure to do so can significantly delay your new provider from being eligible to see patients and get paid. Even […]Learn More
There is a lot riding on you accurately keeping track of your provider’s numerous credentialing and enrollment obligations. If something falls through the cracks, or if the information is not 100% accurate, they can be left with no way to get paid for the services they provide. Whether you are managing payer credentialing requests, updating hospital applications or adding a […]Learn More