The improper payment rate for routine venipuncture lab tests was 16.3% in 2018, representing more than $20 million, and medical necessity errors accounted 98.9% of the improper payments, according to CMS.Read More »
On January 29, NAHRI presented its first members-only quarterly call of the year, where members heard from revenue integrity experts on engaging clinical staff, chargemaster updates, and addressing denials at their root cause.Read More »
It’s hard to believe planning for the 2019 Revenue Integrity Symposium (RIS) is already underway. It feels like just yesterday we were all gathered in Phoenix exchanging ideas, learning about the latest regulatory changes, and soaking up that desert sun at 2018 RIS. The symposium is NAHRI’s...Read More »
A proposed rule that would expand the use of prior authorization and step therapy for Part D and Medicare Advantage beneficiaries has earned criticism from patient advocacy groups and praise from pharmacy groups.Read More »
It’s nearly time to head back to the National Association of Healthcare Revenue Integrity’s 2018 Revenue Integrity Symposium, and I couldn’t be more excited. I attended and presented at last year’s symposium and came back with a wealth of information...Read More »
The high volume of successful appeals, particularly on the first level, raises concerns that Medicare Advantage Organizations were denying payment and authorization for services that should have been provided, the OIG said.Read More »
