Payer contract terms have far-reaching consequences, from the types of services covered and the documentation required to how appeals are negotiated. Learn how revenue integrity can collaborate with physician advisors to monitor and address problems with payer contracts.Read More »
CMS released the 2020 OPPS proposed rule July 29, proposing to refine previous policies related to price transparency and the 2-midnight rule, moving forward with year two of the site-neutral payment policy for clinic visits, while also asking for comments on how to potentially undo its policy...Read More »
Facilities need to know how to respond to documentation requests as part of any Medicare audit or review. Preparing a complete and proper reply makes all the difference in the outcome or results of those audits and reviews.Read More »
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is key to revenue integrity success. Understanding its benefits and limits is important for any successful revenue integrity program.Read More »
As part of its Patients Over Paperwork initiative, CMS is collecting public input on ways to reduce unnecessary administrative and regulatory burden.Read More »
In the spirit of Revenue Integrity Week, which is designed to celebrate the diligence and dedication of revenue integrity professionals, NAHRI’s State of the Revenue Integrity Industry Survey once again took a deep dive into the roles of revenue integrity professionals, the activities they are...Read More »
Commercial and government payers track chronic conditions using Hierarchical Condition Category (HCC), and providers can track HCCs to better monitor and project reimbursement and compliance.Read More »
