More payers and providers are using the independent dispute resolution (IDR) process than the government anticipated to settle payment for items and services covered by the No Surprises Act.Read More »
NAHRI has extended the deadline to submit application to speak at the 2023 Revenue Integrity Symposium (RIS), to be held September 18‒19 in Charlotte, North Carolina. The deadline to submit applications is Sunday, January 29.Read More »
The American Medical Association (AMA) released four new Current Procedural Terminology (CPT®) codes for bivalent COVID-19 vaccines for young children.Read More »
Q: If an anesthesiologist performs a presurgical or postsurgical block for pain control and it is performed in a holding area rather than in the operating room (OR), can we bill a separate facility (technical) fee for that? Or would this be bundled with OR services?Read More »
The Office of Inspector General (OIG) recently released its annual report on solutions to reduce fraud, waste, and abuse in HHS programs. In the OIG’s 2022 report, 16 of the top 25 unimplemented recommendations involve CMS, with three relating to Medicare Parts A and B.Read More »
Better-performing revenue integrity programs have clear objectives with defined roles and expectations. This prevents overlap between functions, including those of the billing office, compliance, internal audit, and clinical operations. Your...Read More »
CMS released a proposed rule on December 6 to promote transparency, efficiency, and automation in prior authorization processes. Certain requirements in the proposed rule are also intended to improve data accessibility for patients, providers, and payers.Read More »
CMS extended enforcement discretion, pending future rulemaking, for providing good faith estimates (GFE) for uninsured or self-pay patients that include price estimates from co-providers or co-facilities. The agency announced the pause in a December 2 FAQ, citing technical limitations.Read More »
