The improper payment rate for routine venipuncture lab tests was 16.3% in 2018, representing more than $20 million, and medical necessity errors accounted 98.9% of the improper payments, according to CMS.Read More »
Q: We recently had a consultant recommend that we create evaluation and management (E/M) levels for our labor and delivery observation cases, similar to our emergency room levels. Does anyone do this? If so, would you be willing to share your criteria and logic used?Read More »
CMS recently reissued Special Edition MLN Matters 19002 to address lingering provider questions surrounding the application of the 2-midnight rule to total knee arthroplasty (TKA) claims. The MLN Matters article was originally released January 8 but was reissued January 24 to...Read More »
The National Association of Healthcare Revenue Integrity is currently seeking speakers to present at the 2019 Revenue Integrity Symposium, to be held October 15–16, 2019, at the Renaissance Orlando at SeaWorld in Orlando, Florida.Read More »
On January 29, NAHRI presented its first members-only quarterly call of the year, where members heard from revenue integrity experts on engaging clinical staff, chargemaster updates, and addressing denials at their root cause.Read More »
A Comprehensive Error Rate Testing (CERT) study showed that insufficient documentation causes most improper payments for observation and inpatient care services, according to the January 2019 Medicare Quarterly Compliance Newsletter.Read More »
It’s hard to believe planning for the 2019 Revenue Integrity Symposium (RIS) is already underway. It feels like just yesterday we were all gathered in Phoenix exchanging ideas, learning about the latest regulatory changes, and soaking up that desert sun at 2018 RIS. The symposium is NAHRI’s...Read More »
