When organizations receive a charge denial from a commercial payer, they must weigh their options to determine whether challenging the decision will be worthwhile.
The first step is identifying the basis of the denial. If the organization can’t determine the payer’s reasoning by reviewing...Read More »
Gain insights into CMS’ and the Office of Inspector General’s audit targets and learn how to put this knowledge to work at your organization.Read More »
The Office of Inspector General (OIG) highlighted several congressional actions that, if taken, could lead to $17 billion in potential cost savings across HHS programs.Read More »
CMS recently published the April 2025 Outpatient Prospective Payment System (OPPS) update to highlight coding changes for skin substitute products that took effect on April 1.Read More »
Understanding national trends in salary, compensation, and career paths is essential to knowing your worth, planning for your career to grow, and managing a competitive revenue integrity program. That’s why NAHRI has released the 2025 Revenue Integrity Salary Survey.Read More »
Q: If a provider documents sepsis with acute kidney injury but does not explicitly link the two conditions, should they be queried to prevent the claim from being denied?Read More »
