The 2020 calendar year was certainly challenging for revenue integrity professionals, as the novel coronavirus (COVID-19) pandemic stressed the workforce, necessitated new working environments, and led to frequent regulatory updates. Through case studies, news, and analysis in the weekly Revenue...Read More »
Q. The IFC for MFN states on pp. 122–123, “Because Medicare allows the lesser of the applicable payment amount or the billed amount, MFN participants will have to ensure that they submit an appropriate billing amount (or charge) for the alternative add-on for the applicable quarter.” The OPPS is...Read More »
NAHRI’s Revenue Integrity Symposium 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? NAHRI is currently seeking healthcare professionals who are...Read More »
The 2021 Outpatient Prospective Payment System (OPPS) final rule, released December 2, moves ahead with most of the provisions of the proposed rule. This should come as a relief to hospitals required to implement most of its policies by January 1, 2021.Read More »
The 2021 Medicare Physician Fee Schedule (MPFS) final rule, released December 2, extends certain telehealth benefits but makes cuts to the Medicare conversion factor (CF) to offset evaluation and management (E/M) changes that would otherwise have resulted in significant reimbursement increases....Read More »
CMS announced on November 25 that it is building on the flexibilities granted by the Hospitals Without Walls program to launch the Acute Hospital Care at Home program. Under this program, eligible hospitals will be allowed to treat certain inpatients in the patient’s home.Read More »
United Healthcare (UHC) recently announced that it is delaying the implementation date of its unique laboratory code policy. The policy, which was originally set to go into effect January 1, 2021, will be delayed until January 1, 2022.Read More »
