Articles

Revenue Integrity Insider

2025 OPPS proposed rule: Separate payment for radiopharmaceuticals, new obstetrical CoPs in the balance

Wednesday, July 17, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

CMS is considering a significant change to how it pays for certain high-cost radiopharmaceuticals, as well as a sweeping new set of Conditions of Participation (CoPs) aimed at maternal health, and a slew of other changes in the 2025 Outpatient Prospective Payment System (OPPS)...Read More »

Revenue Integrity Insider

2025 MPFS proposed rule: New codes and modifiers, major changes to telehealth and MSSP in the works

Wednesday, July 17, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Organizations could see a flood of new codes along with significant changes to the Medicare Shared Savings Program (MSSP) and coverage of telehealth services, according the 2025 Medicare Physician Fee Schedule (MPFS) proposed rule.Read More »

NAHRI Journal - Volume 8, Issue 3

Download the July 2024 issue of the NAHRI Journal

Wednesday, July 10, 2024
Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Celebrate your journey and acknowledge your success.Read More »

NAHRI Journal - Volume 8, Issue 3

Acknowledging your milestones

Wednesday, July 10, 2024
Revenue Integrity

Acknowledge your milestones and celebrate your success.Read More »

NAHRI Journal - Volume 8, Issue 3

Establishing a denial prevention program

Wednesday, July 10, 2024
Denials and Appeals, Program Management, Revenue Integrity

Erin Brearley Cutter, MBA, CHRI, CRCR, COC, CPC, shares how an effective denials prevention program has made an impact at her organization.Read More »

NAHRI Journal - Volume 8, Issue 3

2025 IPPS proposed rule: Major changes to outlier payments, NTAP, and more

Wednesday, July 10, 2024
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Consider how CMS’ proposed changes for 2025 could affect hospitals.Read More »

NAHRI Journal - Volume 8, Issue 3

2025 IPPS proposed rule: MS-DRG and code updates

Wednesday, July 10, 2024
Coding and Documentation, Reimbursement and Payment Methodologies, Revenue Integrity

Catch up on proposed changes to MS-DRGs and reimbursement in the 2025 Inpatient Prospective Payment System (IPPS) proposed rule.Read More »

NAHRI Journal - Volume 8, Issue 3

2025 IPPS proposed rule: Social determinants of health flagged as CCs

Wednesday, July 10, 2024
Coding and Documentation, Reimbursement and Payment Methodologies, Revenue Integrity

CMS is proposing to upgrade certain codes describing social determinants of health to better capture the effect of housing instability on beneficiaries, according to the fiscal year 2025 Inpatient Prospective Payment System (IPPS) proposed rule.Read More »

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