Revenue Integrity Insider

Line item removal of cardiac implants: Revenue integrity’s next challenge

Wednesday, June 9, 2021
Billing and Claims, Chargemaster and Charge Capture, Compliance, Coverage, Revenue Integrity

Ronald Hirsch, MD, FACP, CHCQM, CHRI, examines recent changes to commercial payer prior authorization requirements and how it affects revenue integrity.Read More »

Revenue Integrity Insider

CMS removes two codes from prior authorization list

Wednesday, May 19, 2021
Billing and Claims, Coding and Documentation, Compliance, Coverage, News, Revenue Integrity

Two CPT® codes are temporarily suspended from the prior authorization program for hospital outpatient departments, CMS announced.Read More »

Revenue Integrity Insider

CMS updates telehealth list, cautions organization to pay attention to billing rules

Wednesday, April 21, 2021
Billing and Claims, Coding and Documentation, Coverage, News, Revenue Integrity

CMS released an updated list of Medicare telehealth services while cautioning organizations to pay close attention to telehealth billing rules.Read More »

NAHRI Journal - Volume 5, Issue 1

2021 MPFS final rule: Charting a new path for E/M and telehealth

Wednesday, January 13, 2021
Coding and Documentation, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Take a look at the revenue integrity impact of CMS’ changes to telehealth and E/M.Read More »

NAHRI Journal - Volume 5, Issue 1

Download the January 2021 issue of the NAHRI Journal

Wednesday, January 13, 2021
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Reimbursement and Payment Methodologies, Revenue Integrity

Get a fresh perspective on revenue integrity for the new year.Read More »

NAHRI Journal - Volume 5, Issue 1

Navigating PHE telehealth changes and Hospitals Without Walls

Wednesday, January 13, 2021
Billing and Claims, Compliance, Coverage, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Christian S. Gabriel breaks down CMS’ expanded coverage for hospital outpatient telehealth.Read More »

NAHRI Journal - Volume 5, Issue 1

2021 OPPS final rule: Inpatient-only list eliminated, prior authorization expanded

Wednesday, January 13, 2021
Billing and Claims, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Understand the ins and outs of CMS’ major new policies.Read More »

Revenue Integrity Insider

2021 OPPS final rule starts the clock on inpatient-only elimination, adds services to prior authorization list

Wednesday, December 9, 2020
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

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 »

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