Ask NAHRI

Q: What should revenue integrity teams at short-term acute care hospitals keep in mind before analyzing Program for Evaluating Payment Patterns Electronic Report (PEPPER) findings?

Q: How can revenue integrity teams validate reimbursement performance for skin substitute products?

Q: What should organizations consider before appealing a denial? What indicators suggest that an appeal would not be appropriate?

Q: What background and skills should a chargemaster professional have if they are looking to advance into a managerial role?

Q: How do you handle clinical validation denials when payers say you won’t receive payment unless you remove a code from the claim? 

Q: How are revenue integrity departments using generative artificial intelligence (GenAI) to carry out specific functions?

Q: Why is it important to respond to additional documentation requests (ADR) in a timely manner?

Q: How can we improve correct use of drug waste modifiers on skin substitute claims?

Q: What elements need to be in the documentation to ensure complete reimbursement for skin substitute claims?

Q: If a provider documents sepsis with acute kidney injury but does not explicitly link the two conditions, should they be queried to prevent the claim from being denied?