Medicare made $54.4 million in improper payments to acute care hospitals for post-acute transfers that did not comply with Medicare’s policies, according to a November 1 report from the Office of Inspector General (OIG).Read More »
The American Hospital Association (AHA) and other hospital groups argue that the final rule is unlawful because it exceeds CMS' statutory authority.Read More »
Earning credentials are a career milestone but preparing for the exam is a challenge for even the savviest professional. The Certification in Healthcare Revenue Integrity (CHRI) Practice Exam can help you gain confidence and brush up on your test-taking skills.Read More »
Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e. C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines...Read More »
Expanded price transparency requirements are set to become reality for hospitals effective January 1, 2021. On November 15, CMS released a final rule that pushed ahead with many of the requirements originally included in the 2020 OPPS proposed rule.Read More »
The Patient-Driven Payment Model (PDPM) has so many nuances that can impact reimbursement that it is near impossible for SNFs to consider and capitalize on them all. Check your processes and procedures to ensure you’re taking advantage of or protecting against the following aspects of PDPM. ...Read More »
NAHRI is currently accepting applications for its board and committees. Taking an active role in NAHRI can set you on the path to shape the future of the revenue integrity profession as well as advance your career.
CMS is moving forward with multiple policies—effectively based on reducing reimbursement to hospitals—that have been deemed unlawful in court, according to the 2020 OPPS final rule, released Friday, November 1.Read More »
