Healthcare organizations are under more and more pressure from denials, impacting hospitals’ bottom lines and ultimately resources they have available to care for patients. Those in the revenue integrity and clinical documentation integrity (CDI) fields are
Denials management is critical for providers facing rising denial rates, especially in medical necessity claims, which can delay cash flow and increase appeal costs.
To maintain financial stability and operational efficiency, healthcare organizations must enhance clinical...
Listening to a NAHRI Quarterly Call (free for NAHRI members) qualifies for one CHRI CEU credit upon the completion of the accompanying survey. If you’re a NAHRI member and are interested in presenting on an upcoming NAHRI members-only call, please contact NAHRI at...
CMS is considering a significant change to how it pays for certain high-cost radiopharmaceuticals, as well as a sweeping new set of Conditions of Participation (CoPs) aimed at maternal health, and a slew of other changes in the 2025 Outpatient Prospective Payment System (OPPS) proposed rule.
Organizations could see a flood of new codes along with significant changes to the Medicare Shared Savings Program (MSSP) and coverage of telehealth services, according the 2025 Medicare Physician Fee Schedule (MPFS) proposed rule.
This sample policy was provided to the National Association of Healthcare Revenue Integrity (NAHRI) by Erin Brearley Cutter, MBA, CHRI, CRCR, COC, CPC, revenue integrity director at Concord Hospital Health System in New Hampshire.
