CMS finalized a higher-than-proposed payment increase that was almost erased for most non-drug services to offset ending reduced reimbursement for 340B drugs, according to the...Read More »
CMS is moving ahead with major changes to evaluation and management (E/M) services, telehealth, coverage of dental services, and more in the 2023 Medicare Physician Fee Schedule (MPFS) final rule. The rule, released November 1, also includes updates to vaccine payments and quality and reporting...Read More »
Q: My team and I are responsible for clinical documentation improvement (CDI). We’re considering adding a reconciliation element to our CDI review process next year. In your experience, what’s been the biggest benefit of performing reconciliation on charts?Read More »
The Medical Group Management Association (MGMA) released its Annual Regulatory Burden Report on October 11. Executives from over 500 group practices said prior authorization and surprise billing requirements were the most burdensome to implement this year.Read More »
It’s helpful to understand payer-specific contract terms and government billing requirements when developing work lists or work queues and reports. Analyzing data that comes from claim scrubber edits, return to provider edits, variances, and denials can provide insight into repetitive issues...Read More »
As hospitals and health systems face worsening margins, members of the NAHRI Leadership Council share research and strategies to advance revenue integrity and address critical reimbursement challenges.Read More »
The Office of Inspector General (OIG) recently announced it will audit CMS’ monitoring and enforcement of the Hospital Price Transparency final rule. The report is expected for release in 2023.Read More »
Q: We are a critical access hospital (CAH). We provide smoking cessation therapy (CPT codes 99406-99407) in our cardiac rehab department. The documentation is done and signed by a respiratory therapist (RT), and we are currently billing this as a professional charge (on a UB-04 with revenue code...Read More »
