Revenue Integrity

Check out these recommended opportunities and make the most of the last few weeks of the year.

Q: How are revenue integrity departments using generative artificial intelligence (GenAI) to carry out specific functions?

While communication is key to reducing denials, it’s very difficult to do well, according to Nancy Blattberg-Smith, MPH, RHIA, CDIP, CCS,

CMS is preparing to launch the Outpatient Prospective Payment System (OPPS) Drug Acquisition Cost Survey to collect acquisition costs for certain outpatient drugs and biologicals.

CMS recently created a new system edit to help reduce improper Medicare payments for outpatient services provided by acute care hospitals to hospice patients.

CMS moved ahead with significant expansions to its site neutral payment policies, including reductions to payments for certain services at expected off-campus provider based departments (PBD), additional price transparency requirements, changes to its methodology for setting MS-DRG rates, and more, according to the 2026 Outpatient Prospective Payment System (OPPS) final rule.

Governmental audits are handled differently at every facility, but favorable results are more likely with a strong audit response that meets all AD