The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a treasure trove of data that can help hospitals adapt to the world of value-based purchasing, reduce risk, and stay ahead of audits. But understanding how to...
Is your hospital’s chargemaster updated for 2017? Learn about the latest billing and coding changes affecting the chargemaster and how to ensure your hospital’s chargemaster is in top form to help ensure revenue integrity....
Claims returned with NCCI edits or medically unlikely edits (MUE) can easily be lost in the shuffle. Often, it’s not clear who is responsible for resolving an edit, leading to further delays with accounts receivable. Properly...
Every piece of a cost report tells CMS your facility’s story, and it’s your responsibility to ensure the story is accurate. The data included on cost reports can impact a facility’s revenue for years to come—influencing payment on...
This document provides guidance on key performance indicators for denials management and revenue integrity, including calculations for denials rates and denials overturn ratios.
This chart outlines the components of revenue integrity and can help make your revenue integrity program a high reliability system improving margins and patient satisfaction.
The staff of Community Hospital Anderson in Anderson, Indiana, knows a thing or two about prioritization. Not having a separate department dedicated to revenue integrity, their staff balances their revenue cycle roles with their revenue integrity-specific projects.
