NAHRI |

How to respond to commercial payer line item denials

Fri, 05/16/2025

Billing and Claims, Chargemaster and Charge Capture, Denials and Appeals, NAHRI Leadership Council, Revenue Integrity

When organizations receive a charge denial from a commercial payer, they must weigh their options to determine whether challenging the decision wil

OIG identifies $17 billion in potential cost savings

Wed, 05/14/2025

Revenue Integrity Insider

Billing and Claims, Compliance, Monitoring and Audits, News, Reimbursement and Payment Methodologies, Revenue Integrity

The Office of Inspector General (OIG) highlighted several congressional actions that, if taken, could lead to $17 billion in potential cost savings across HHS programs.

Successfully managing audits and avoiding compliance pitfalls

Wed, 05/14/2025

Revenue Integrity Insider

Billing and Claims, Coding and Documentation, Compliance, Revenue Integrity

Gain insights into CMS’ and the Office of Inspector General’s audit targets and learn how to put this knowledge to work at your organization.

Tackling medical necessity denials

Wed, 05/07/2025

Revenue Integrity Insider

Denials and Appeals, Revenue Integrity

Learn how to reduce medical necessity denials by developing a strong partnership with clinical teams.

Report: Key trends impacting hospital financial stability in 2025

Wed, 05/07/2025

Revenue Integrity Insider

News, Program Management, Reimbursement and Payment Methodologies

A recent American Hospital Association report examines the current financial pressures facing hospitals and health systems.

Skin substitute coding changes in the April 2025 OPPS update

Wed, 04/30/2025

Revenue Integrity Insider

Coding and Documentation, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS recently published the April 2025 Outpatient Prospective Payment System (OPPS) update to highlight coding changes for skin substitute products that took effect on April 1.

Leveraging CDI to reduce revenue leakage and denials

Wed, 04/30/2025

Revenue Integrity Insider

Coding and Documentation, Revenue Integrity

Gan insights into how CDI can help shore up revenue integrity for office visits and ancillary services.