David J. Zetter
Senior Healthcare Consultant
PHR, SHRM-CP, CHCC, CPCO, CPC, COC, PCS, FCS, CHBC, CMUP, PESC, CMAP, CMAPA, CMMP
David Zetter is the founder and lead consultant with Zetter HealthCare 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 is 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, NPPES and QPP environment, conducts beta testing of the EHR/HITECH & QPP 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. His firm also works with CAQH Proview to suggest improvements and beta test the system.
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.
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, DecisionHealth, Part B News, Part B Insider, and many others, to be interviewed, 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 current member of the Executive Board of Directors for the National Society of Certified Healthcare Business Consultants. He is currently on the Education Committee and serves as Marketing Committee Co-Chair 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.
- Villanova University
- Delta College
- Professional in Human Resources – HRCI (PHR)
- Certified Healthcare Compliance Consultant (CHCC)
- Certified Professional Compliance Consultant – HCR (CHCC)
- Certified Professional Coder - AAPC (CPC)
- Professional in Human Resources (PHR)
- Certified Professional Coder – Hospital - AAPC (CPC-H)
- Physician Coding Specialist – AHIMA/ACMCS (PCS)
- Facility Coding Specialist – AHIMA/ACMCS (FCS)
- Certified Healthcare Business Consultant (CHBC)
- Certified Meaningful Use Professional (CMUP)
- Certified Professional Compliance Officer – AAPC (CPCO)
- Certified Professional Coder – AAPC (CPC)
- Certified Outpatient Coder – AAPC (COC)
- Professional Coding Specialist – AHIMA/ACMCS (PCS)
- Certified Healthcare Business Consultant – NSCHBC (CHBC)
- Provider Enrollment Specialist Certificate (PESC)
- Certified MACRA-MIPS ACI Professional (CMAP)
- Certified MACRA-MIPS Professional Accelerated (CMAPA)
- Certified MACRA-MIPS Proficiency (CMMP)