Hospitals are reinventing their approach to denials to meet today’s challenges—and get ahead of future shifts in payer tactics. They know that the payer landscape has undergone a tremendous shift in recent years, with Medicare Advantage (MA) overtaking traditional Medicare in many markets and...
Hospitals aren’t just reacting to denials anymore—they’re redesigning the playbook. As commercial and Medicare Advantage (MA) denials grow more complex, organizations are taking strategic, cross-functional approaches to manage them. Revenue integrity teams are leveraging analytics to detect...
This sample billing, coding, and documentation policy was developed by revenue integrity and compliance staff at Spire Orthopedic Partners in Stamford, Connecticut, and contributed by 2025 NAHRI Leadership Council member Sandra Giangreco Brown, MHA, RHIT, CCS-P, CHC, CPC, COC, CHRI, COBGC, PCS,...
This sample hospital outpatient department E/M Level visit calculator for facility charges was submitted by 2025 NAHRI Leadership Council member Jaclyn Loewen, CPC, revenue integrity manager at UF Health Shands in Gainesville, Florida.
NAHRI Leadership Council members are encouraged to display these badges with pride in email signatures, social media accounts, and more to demonstrate their standing in the revenue integrity profession.
