Revenue Integrity Insider

2022 OPPS proposed rule: CMS increases price transparency penalties, backs off from eliminating inpatient-only list

Wednesday, July 21, 2021
Billing and Claims, Compliance, News, Reimbursement and Payment Methodologies, Revenue Integrity

Less than a year after CMS finalized the three-year phaseout of the inpatient-only (IPO) list to be completed by 2024, the agency is looking to reverse course, according to the 2022 OPPS proposed rule, released Monday, July 19.Read More »

NAHRI Journal - Volume 5, Issue 3

Condition code case studies

Wednesday, July 7, 2021
Billing and Claims, Compliance, Revenue Integrity

Consider these case studies to understand how to apply condition codes 44 and W2.Read More »

NAHRI Journal - Volume 5, Issue 3

Download the July 2021 issue of the NAHRI Journal

Wednesday, July 7, 2021
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Reach the next level of revenue integrityRead More »

NAHRI Journal - Volume 5, Issue 3

In the balance: Weighing the benefits of self-denial and condition code 44

Wednesday, July 7, 2021
Billing and Claims, Compliance, Revenue Integrity

Gain a fresh perspective on methods to efficiently address patient status changes.Read More »

NAHRI Journal - Volume 5, Issue 3

Connecting the dots: Revenue integrity and utilization review

Wednesday, July 7, 2021
Billing and Claims, Compliance, Program Management, Revenue Integrity

Consider how revenue integrity and utilization review teams can work together to meet shared goals.Read More »

NAHRI Journal - Volume 5, Issue 3

Keeping tabs on compliance with internal audits and monitoring

Wednesday, July 7, 2021
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Monitoring and Audits, Revenue Integrity

Learn how to use regular internal audits and monitoring to boost compliance in revenue integrity areas.Read More »

Revenue Integrity Insider

HHS: New rule limits balance billing, creates processes for calculating out-of-network payment for emergency services

Wednesday, July 7, 2021
Billing and Claims, Compliance, News, Revenue Integrity

Balance billing for emergency services and certain other services will be subject to new limitations, according to an interim final rule with comment period released July 1 by HHS.Read More »

NAHRI Journal - Volume 5, Issue 3

Medicare prior authorization: Understanding and applying CMS updates

Wednesday, July 7, 2021
Billing and Claims, Compliance, Coverage, Revenue Integrity

Brush up on the most recent changes to Medicare’s prior authorization requirements and their operational impact.Read More »

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