Significant Medicare PHE extensions and adjustments: Physician services

Wed, 04/12/2023 - 09:31
Policies & Procedures
Billing and Claims, Coding and Documentation, Compliance, Coverage, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Use these charts to identify extensions and end dates for COVID-19 public health emergency (PHE) waivers and flexibilities and effected services for physician services.

Significant Medicare PHE extensions and adjustments: Rural health clinics and Federally Qualified Health Centers

Wed, 04/12/2023 - 09:30
Policies & Procedures
Billing and Claims, Coding and Documentation, Compliance, Coverage, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Use these charts to identify extensions and end dates for COVID-19 public health emergency (PHE) waivers and flexibilities and effected services in rural health clinics and Federally Qualified Health Centers.

Significant Medicare PHE extensions and adjustments: Hospitals and critical access hospitals

Wed, 04/12/2023 - 09:25
Policies & Procedures
Billing and Claims, Coding and Documentation, Compliance, Coverage, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Use this chart to identify extensions and end dates for COVID-19 public health emergency (PHE) waivers and flexibilities and effected services in hospitals and critical access hospitals.

NAHRI Quarterly Call - January 31, 2023

Tue, 01/31/2023 - 15:26
Quarterly Calls
Reimbursement and Payment Methodologies, Revenue Integrity

Listening to NAHRI Quarterly Conference 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...

Planning for the end of PHE waivers

Fri, 01/20/2023
Leadership Council Insider
Billing and Claims, Compliance, Monitoring and Audits, NAHRI Leadership Council, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

As we start 2023, one of the biggest questions is the fate of the COVID-19 public health emergency declaration (PHE).

Download the January 2023 issue of the NAHRI Journal

Wed, 01/18/2023
NAHRI Journal - Volume 7, Issue 1
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Look ahead to a bright future in revenue integrity.

Weighing gains and losses in the 2023 OPPS final rule

Wed, 01/18/2023
NAHRI Journal - Volume 7, Issue 1
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how CMS’ changes will affect hospital reimbursement.

Unlocking key changes in the 2023 MPFS final rule

Wed, 01/18/2023
NAHRI Journal - Volume 7, Issue 1
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Reimbursement and Payment Methodologies, Revenue Integrity

Ensure you’re complying with new rules for billing and coding.

Advocacy in Action: Commenting on Proposed Rules

Wed, 01/04/2023 - 17:07
White Papers
Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

 In this position paper, the NAHRI Advisory Board breaks down the steps involved in writing and submitting comments on proposed rules and policy changes and discusses why this activity is essential for revenue integrity professionals.

2023 OPPS final rule reduces some payments to offset restored 340B reimbursement

Wed, 11/09/2022
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS finalized a higher-than-proposed payment increase that was almost erased for most non-drug services to offset ending reduced reimbursement for 340B drugs, according to the 2023 Outpatient Prospective Payment System (OPPS) final rule. Provisions of the rule, released November 1, also detail significant changes to payment for software as a service (SaaS) and behavioral and rural health programs, such as the rural emergency hospital (REH) designation, among other updates.

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