CMS revises deadline for reprocessing certain provider-based department claims

Wed, 09/15/2021
Revenue Integrity Insider
Billing and Claims, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS will begin reprocessing 2019 claims for some services rendered at excepted off-campus provider-based departments. The affected claims are for...Read More »

Payer charge audits: Enhancing room and bed charge SOP for documented processes

Fri, 08/20/2021
Leadership Council Insider
Billing and Claims, NAHRI Leadership Council, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Successfully responding to payer charge audits for services billed above room and bed rate can be a challenge. The Cleveland Clinic contracting,...Read More »

2021 Revenue Integrity Symposium kicks off with expert advice on hot topics and collaborative discussions

Wed, 08/18/2021
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Denials and Appeals, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Speakers and registrants shared tips and insights into revenue integrity hot topics on day one of the 2021 Revenue Integrity Symposium, held...Read More »

CMS releases FY 2022 IPPS final rule: MS-DRG overhaul, NTAP/NCTAP updates

Fri, 08/06/2021
Revenue Integrity Insider
Billing and Claims, Reimbursement and Payment Methodologies

CMS released the fiscal year (FY) 2022 IPPS final rule on Monday, August 2, which finalizes its efforts to cushion the ongoing impact of the COVID...Read More »

2022 OPPS proposed rule: CMS increases price transparency penalties, backs off from eliminating inpatient-only list

Wed, 07/21/2021
Revenue Integrity Insider
Billing and Claims, Compliance, News, Reimbursement and Payment Methodologies, Revenue Integrity

Less than a year after CMS finalized the three-year phaseout of the inpatient-only (IPO) list to be completed by 2024, the agency is looking to...Read More »

2022 MPFS proposed rule: Conversion factor cut, telehealth and AUC updates

Wed, 07/14/2021
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS is proposing a 4% decrease to the Medicare conversion factor, permanent expansion of telehealth coverage for some mental health services, and...Read More »

Download the July 2021 issue of the NAHRI Journal

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Reach the next level of revenue integrityRead More »

2022 IPPS proposed rule: CMS hits reset button on MS-DRG changes, offers relief for strained hospitals

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Coding and Documentation, Reimbursement and Payment Methodologies, Revenue Integrity

Take a closer look at how CMS’ proposed changes could transform hospital reimbursement.Read More »

Code updates

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Coding and Documentation, Reimbursement and Payment Methodologies, Revenue Integrity

Review proposed code updates from the fiscal year 2022 Inpatient Prospective Payment System proposed rule.Read More »

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