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. David is nationally recognized for his presentations and expertise. He is well versed in regulatory requirements, revenue cycle management, credentialing and contracting, compliance, coding and documentation. He is considered 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, marketing, fee structures, use of ancillary services and financial considerations; developing strategic plans to improve profitability and productivity. His activities in management and compliance include physician practices, IDTFs, hospitals, ASCs, pharmacy, DME and other facility types, including 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, so he has knowledge of what the expectations are from the payers.
David’s firm works with healthcare professional clients and facilities coast to coast, in all areas of practice and facility management including start‐ups, buy‐ins, compensation, exit strategies, reimbursement enhancement, practice financial modeling, governance documentation, policy and procedure development and implementation, credentialing and contracting, human resources staffing and management, compliance, coding and chart reviews, physician education and many other areas. David has helped to maximize both profitability and reimbursement of physician practices, facility and ambulatory practices, re‐engineered operational and human resources, and addressed coding and billing issues for providers to curtail fraud, abuse, kickback, OIG, and IRS issues. He is also an original member of CMS’ PECOS Power User Group, CMS Compliance Focus Group and MIPS Design Lean Work Group which provides feedback and recommendations to Medicare’s Center for Program Integrity and Provider Enrollment Operations Group on design and improvements to the PECOS enrollment environment, as well as, NPPES and MIPS and conducts beta testing of the EHR/HITECH user interfaces and environments at the request of the Office of e‐Health Standards & Services Director. 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, human resource, coding and compliance education and seminars in many states over the past twenty‐five years. David speaks often on a variety of practice management subjects at hospital residency programs, the National Society for Certified Healthcare Business Consultants, the Medical Management Group Association, the American Academy of Professional Coders, AHIMA, Florida Institute of Certified Public Accountants, Florida Medical Society, many other venues and is often called upon by the MGMA, HFMA, Decision Health, Part B News, Part B Insider, and many others, to conduct audio conferences and webinars. He has been published in Medical Economics and interviewed and quoted in many publications including Report on Patient Privacy and Report on Medicare Compliance.
David is a past President and current Executive Board Member of the National Society of Certified Healthcare Business Consultants. He has served on the Education Committee for more than twenty years and is a Certified Healthcare Business Consultant. He is a member of the Society for Human Resource Management and is a past Professional Development Chair and past Vice President of Human Resource Professionals of Central PA. David is also a past board member of the Central PA affiliate chapter of the American Academy of Professional Coders and is certified as a Professional Coder for physician practices, hospitals, and facilities. David is also a Certified Compliance Consultant and Officer. David is also a member of the American Health Lawyers Association, the Medical Group Management Association, and the Healthcare Financial Management Association.
David advises on and publishes operations policies and procedures manuals, employee handbooks, compliance manuals, HIPAA and OSHA and has published articles in numerous healthcare and human resource related magazines on subjects like coding and compliance, interviewing, recruitment, evaluations and disciplinary processes.
Training Sessions by David J. Zetter
Provider credentialing and enrollment are time-consuming tasks, but if you don’t do them on time — and accurately — you can forfeit thousands in reimbursement. Unfortunately, the payer enrollment portals are not intuitive, making it challenging to avoid costly mistakes. The good news is that provider enrollment expert Tracey Tokheim, credentialing specialist Tammy West MHA/ED, CPMSM, CPCS and practice management expert David […]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
Ever wonder why payers don’t share information about how ERISA protects your practice from wrongful denials and chargebacks? The answer is simple: Because they don’t want you to know how much money you can retain by protecting your practice with proven ERISA strategies. Insurers make money every time you simply accept a denial. When they don’t have to pay you […]Learn More
Negotiating managed care contracts may make you feel like you’re talking to a brick wall. Unfortunately, insurers want you to feel that way, because if they stonewall you, the odds that you’ll simply sign whichever documents they put in front of you increase exponentially. Your best bet for negotiating contract terms that will work in your favor is to recognize […]Learn More