How Pre-Bill Revenue Integrity as a Service is Transforming Revenue Cycle Management

Mon, 06/01/2020 - 16:09
White Papers
Reimbursement and Payment Methodologies, Revenue Integrity

To improve financial performance across the enterprise, many providers are taking a novel approach: Pre-Bill Revenue Integrity as a Service, which combines automated pre-bill analysis with revenue integrity expertise. This flexible approach offers many benefits over the traditional approach of...

Potential revenue implications of the CMS utilization review waiver

Tue, 06/02/2020
Revenue Integrity Insider
Compliance, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Although patient care remains the primary concern during COVID-19, the financial effects of the crisis will linger for many months afterward. Maintaining good UR discipline may help hospitals emerge from this emergency in better financial condition and able to better serve their populations.

Q&A: Revenue monitoring

Fri, 06/05/2020
Revenue Integrity Insider
Reimbursement and Payment Methodologies, Revenue Integrity

Q. Nearly 20% of respondents use a vendor-built tool integrated with their EHR to identify revenue leaks. What kind of revenue leakage should revenue integrity aim to identify through the use of this technology?

A. Vendor-built tools can help identify revenue leakage in multiple clinical areas. When starting with a new tool, create a plan to address your hospital’s high-dollar or high-volume areas, as well as specific areas of known concern. 

Note from the Director: Revenue Integrity Week sneak peek

Wed, 05/27/2020
Revenue Integrity Insider
Chargemaster and Charge Capture, Reimbursement and Payment Methodologies, Revenue Integrity

Calling all Revenue Integrity Investigators! Revenue Integrity Week (June 1‒5) is just days away and NAHRI has a lot in store to ensure we all recognize the dedication of revenue integrity professionals while taking some time for education, networking, and most importantly fun.

 

The Revenue Integrity Show: Advocacy Opportunities Now (May 21)

Submitted by jfitzgerald@hcp... on Thu, 05/21/2020 - 16:07

May 21 - Advocacy Opportunities Now: Reviewing and Commenting on COVID-19 Rules and the IPPS Proposed Rule

Featuring NAHRI Professional Advocacy Committee and Advisory Board Members:
  • Terri Rinker, MT (ASCP), MHA, CHRI, Revenue Cycle Director, Community Hospital Anderson
  • John D. Settlemyer, MBA, MHA, CPC, CHRI, Associate VP Revenue Cycle, Atrium Health
  • Jugna Shah, MPH, CHRI, President, Nimitt Consulting Inc.
  • Denise Williams, COC, CHRI, Senior VP, Revenue Integrity Services, REVANT Solutions
Agenda:
  • Members of the NAHRI Professional Advocacy Committee and NAHRI Advisory Board discuss the top points related to COVID-19 rules and the 2021 IPPS proposed rule and offer guidance on submitting comments to CMS. Several rules are open for comment right now and there is no better time than the present to get tips for commenting. 

2021 IPPS proposed rule: MS-DRG changes and new requirements to report negotiated charges

Wed, 05/13/2020
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, News, Reimbursement and Payment Methodologies

CMS’ fiscal year (FY) 2021 Inpatient Prospective Payment System (IPPS) proposed rule, released May 11, proposes new price transparency requirements focused on reporting of negotiated charges.

CMS issues new flexibilities and waivers, permits hospitals to bill for telehealth

Mon, 05/04/2020
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS released a new interim final rule with comment period that grants organizations another round of flexibilities to meet the challenges of the COVID-19 public health emergency, including permitting hospitals to bill for telehealth services and loosening restrictions on COVID-19 testing.

Join us May 7 for The Revenue Integrity Show

Wed, 04/29/2020
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

The next episode of NAHRI’s new podcast, The Revenue Integrity Show, airs Thursday, May 7, at 3 p.m. Eastern. This episode dives into the impact of COVID-19 on revenue integrity from the perspective of a physician and an operations expert.

Stream the April 2020 Quarterly Call

Wed, 04/29/2020
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

The recording of the April 28 members-only Quarterly Conference Call is now available for streaming.

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