Audit defense is a key strategy to ensure coding and billing compliance and defend earned revenue. Pre-payment audits can be notoriously difficult to manage and track. Payers may shave revenue off a claim at different points using different strategies, leaving hospitals struggling to determine...Read More »
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 »
When hospitals or provider entities merge under one system structure, particularly when moving onto a new EMR or practice management system platform, it can be a heavy lift for all parties involved as they work to ensure a successful transition and structure a strong foundation for future growth...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 »
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 »
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 »
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 »
