The demands of the healthcare industry require that professionals become lifelong learners. This is part of the reason why revenue integrity professionals, who are known overachievers in the best sense of the word, are attracted to the field. There is always more to learn and room to grow.Read More »
A federal appeals court on December 29 rejected the hospital industry’s attempt to block CMS’ price transparency rule, effective January 1, that requires hospitals to disclose standard charges, including payer-specific negotiated rates, for 300 services.Read More »
NAHRI’s Revenue Integrity Symposium (RIS) is a fantastic way to network with and learn from revenue integrity professionals from across the country. But have you considered that RIS can also help hone your professional speaking skills? Read More »
Implementation of two historic rules set to implement interoperability and patient access provisions of the Cures Act, have been postponed until April 5, 2021.Read More »
The biggest surprise about the 2021 Outpatient Prospective Payment System final rule, released December 2, 2020, was how few surprises it contained. CMS finalized most policies as proposed or continued with current policies, easing some of the burden on organizations that had a scant few weeks...Read More »
The 2021 Medicare Physician Fee Schedule (final rule, released December 1, 2020, capped a turbulent year with the promise of reimbursement gains for evaluation and management and extended telehealth services, but a steep cut to the Medicare conversion factor.Read More »
Drafting an effective appeal in response to payer audits and overpayment demands goes beyond just coding and billing; it also often requires a deeper analysis and technical response. Let’s take a look at some steps to take and knowledge to have while putting together an appeal. Read More »
Payer enrollment is the cog that kicks off the revenue cycle. Although most revenue cycle renderings indicate client intake is step one in the cycle, the reality is enrollment is the critical first phase. Read More »