Policies and Procedures

AI In Healthcare Payments Software: A Strategic Imperative

Mon, 07/21/2025 - 16:21

Policies and Procedures, Program Management, Revenue Integrity

Next Steps in Denials: Collaborative Solutions, Proactive Moves

Thu, 07/17/2025 - 15:20

Denials and Appeals, Monitoring and Audits, NAHRI Leadership Council, Policies and Procedures, Program Management, Revenue Integrity

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...

Download the July 2025 issue of the NAHRI Journal

Wed, 07/09/2025

NAHRI Journal - Volume 9, Issue 3

Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Payer Contracting, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Get connected to your revenue integrity network.

Chargemaster integrity maintenance policy

Wed, 07/09/2025

NAHRI Journal - Volume 9, Issue 3

Chargemaster and Charge Capture, Policies and Procedures, Revenue Integrity

Use this sample chargemaster integrity maintenance policy as a template for your organization.

How to keep up with changing rules and regulations

Wed, 06/11/2025

Revenue Integrity Insider

Billing and Claims, Coding and Documentation, Compliance, Coverage, Payer Contracting, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how to stay current with and navigate changing reimbursement rules and regulations to protect revenue and avoid compliance pitfalls.

Recipe for Success: 2025 State of the Revenue Integrity Industry

Mon, 06/02/2025

Revenue Integrity Insider

Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Revenue Integrity

Revenue integrity professionals need to understand how new elements in the healthcare industry, from changing regulations to advances in technology

Q&A: Identifying opportunities for expansion

Mon, 06/02/2025

Revenue Integrity Insider

Billing and Claims, Denials and Appeals, Payer Contracting, Policies and Procedures, Program Management, Revenue Integrity

Q: What areas or functions would you like to see your revenue integrity program take a bigger role in?

2025 State of the Revenue Integrity Industry Report

June 2, 2025

Industry Report

NAHRI is celebrating the eighth annual Revenue Integrity Week (June 2–6) to acknowledge and raise awareness of revenue integrity professionals’ incredible contributions in the healthcare industry. To further support the goals and mission of revenue integrity and advance the development of...

CMS publishes new guidance, RFI on price transparency requirements

Wed, 05/28/2025

Revenue Integrity Insider

Chargemaster and Charge Capture, Compliance, News, Policies and Procedures, Revenue Integrity

CMS is taking steps to comply with a recent executive order to improve and prioritize hospital price transparency requirements.

Tackling the Denials Challenge: Smarter Strategies, Stronger Defenses

Wed, 05/14/2025 - 14:06

Council Resources

Denials and Appeals, NAHRI Leadership Council, Policies and Procedures, Program Management, Revenue Integrity

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...

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