Following is the text of NAHRI's comments to CMS on the proposed changes to the Medicare Outpatient Prospective Payment System and proposed calendar year 2025 rates. Download them below. You may use this letter as a template for submitting your own comments to CMS on any of the topics addressed...
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...
Denial prevention continues to be a top priority in today’s healthcare revenue cycle. From optimizing claim submission to activating an appeals plan, you’ll get every action item you need to prevent and overturn denials — plus key metrics to track as you go.
Learn how to adopt an end-to-end platform strategy and help avoid managing multiple vendors, migrate operational and security vulnerabilities associated with maintaining disparate systems, and concentrate on patient care.
Denials are a constant thorn for healthcare organizations, and are often caused by factors outside of an organization’s control, such as to new payer rules or patients switching medical plans. When left unchecked, claim denials can represent an average loss of up to 5% of net patient revenue.
The 2022 NAHRI Leadership Council Survey Part 2 examines claim edit patterns, pre-billing processes, and top payer trends.
In addition to clinical areas, the last two years of the COVID-19 pandemic also introduced massive disruption to the revenue cycle, skewing billing processes and...
Despite investments in both technology and people, clean claim submission that reflects optimized compliant revenue capture still eludes most healthcare organizations. This...
NAHRI Leadership Council shares best practices, resolving top challenges, and working around staffing shortages.
In the 2022 NAHRI Leadership Council survey: Custom Edits—Creation and Workflow, 100 leaders, including revenue integrity, health information management (HIM), and coding...
With thousands of Medicare patients discharged to post-acute care facilities annually, hospitals need to identify claims that failed to transfer under Medicare’s Post-Acute Care Transfer rules....
