Hospitals will be facing lower reimbursement for certain services at expected off-campus provider-based departments (PBD), 340B drugs, and non-drug items and services, according the 2027 Outpatient Prospective Payment System (OPPS) final rule.Read More »
CMS finalized additional cuts to the conversion factor (CF) and new modifiers to replace Healthcare Common Procedure Coding System (HCPCS) code G2211, according to the 2027 Medicare Physician Fee Schedule (MPFS) final rule.Read More »
A new Office of Inspector General (OIG) data brief highlights potential weaknesses in CMS’ and Medicare Administrative Contractors’ (MAC) oversight of Part B outpatient drug billing.Read More »
Revenue integrity staff at physician offices must follow CMS billing guidelines for ITVISMA®, a new gene therapy drug approved to treat certain patients with spinal muscular atrophy.Read More »
Q: What should revenue integrity teams at short-term acute care hospitals keep in mind before analyzing Program for Evaluating Payment Patterns Electronic Report (PEPPER) findings?Read More »
Speaking at the Revenue Integrity Symposium (RIS) is an incredible opportunity for professionals looking to make their mark on the revenue integrity field. Submit your application to speak by January 11, 2027.Read More »
Understanding PEPPER is the first step in using it effectively. Julie Hall, EHRC, CRCR, COC, co-founder and principal consultant at Integrated Revenue Integrity in Sturbridge, Massachusetts. recommends referencing the PEPPER user guide, which is updated with the publication of...Read More »
The NAHRI Leadership Council is a place for leaders like you to connect with likeminded peers to share ideas, solutions, and forge a path to advance the industry and your careers. Here’s a quick rundown of the resources available to Council members and how you can maximize the benefits you get...Read More »
