Revenue integrity leaders looking to make an impact on the professional fee side of their organizations need to understand the unique opportunities and challenges of a professional fee revenue integrity program, as well as the special coding, billing, and reimbursement rules. To make the case to...Read More »
Organizations could see a flood of new codes along with significant changes to the Medicare Shared Savings Program (MSSP) and coverage of telehealth services, according the 2025 Medicare Physician Fee Schedule (MPFS) proposed rule.Read More »
CMS is considering a significant change to how it pays for certain high-cost radiopharmaceuticals, as well as a sweeping new set of Conditions of Participation (CoPs) aimed at maternal health, and a slew of other changes in the 2025 Outpatient Prospective Payment System (OPPS)...Read More »
Kimberly A. Hoy, JD, CPC, discusses how her session at the 2024 Revenue Integrity Symposium will help organizations fight back against improper Medicare Advantage denials.Read More »
CityMD, an urgent care center group, has agreed to pay over $12 million to settle alleged False Claims Act violations related to reimbursement for COVID-19 testing. Read More »
