Most revenue integrity departments are tasked with supporting accurate and consistent charge reconciliation. Homegrown or third-party technology and automation help accomplish this at many organizations, but some revenue integrity departments lean on manual processes to vet charge reconciliation...Read More »
Q: We are experiencing post-payment audits that result in denials of inpatient claims. Our coders and CDI leaders are vehement that the patient meets MCG and/or coding guidelines, but the payer is using clinical results from the patient as their justification. It seems as if they are ignoring...Read More »
The American Medical Association recently announced three new CPT codes for administration of Pfizer’s COVID-19 vaccine in children 6 months to under 5 years old.Read More »
NAHRI is conducting the 2022 State of the Revenue Integrity Industry Survey and is interested in learning about your revenue integrity experience.Read More »
The average rate of denials has climbed steeply over the past several years. Addressing the onslaught of denials calls for a keen eye on trends and an interdepartmental approach designed to shift the organization from a reactive to a proactive stance.
The NAHRI Leadership Council is pleased to invite you to participate in our 2022 NAHRI Leadership Council Survey: Claims Edits. This brief survey will help the NAHRI Leadership Council analyze claims edits from the perspective of workflows, resolution, tracking and monitoring,...Read More »
