Denied claims are a constant burden on many health organizations – often forcing teams to choose between whether to invest time and resources into either denial prevention or denial management. What if you could...
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.
Revenue integrity professionals saw some salary gains over the past year—and they’re more likely to have changed jobs, according to the results of NAHRI’s 2023 Revenue Integrity Salary Survey.
Hospitals need to start preparing for major changes to price transparency requirements, according to the 2024 Outpatient Prospective Payment System (OPPS) final rule, released November 2. The final rule details a slew of changes to price transparency compliance along with reimbursement changes and updates to numerous other programs.
The conversion factor cuts that CMS floated earlier in the year are now confirmed—and heightened. Part B providers will have to prepare for a net 3.4% payment decrease across services in 2024, according to the 2024 Medicare Physician Fee Schedule (MPFS) final rule released November 2.
CMS is moving forward with its proposals to address unlawful payment reductions to 340B drug reimbursement, according to a final rule released November 2. The final rule keeps most of the provisions of the proposed rule intact with only a few adjustments based on commenter feedback.
HHS released a proposed rule on October 27 regarding the federal independent dispute resolution (IDR) process for the No Surprises Act. The rule focuses on early communication between payers and providers, the open negotiation period, batching, eligibility, administrative fee structure, and registration.
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 on an upcoming NAHRI members-only call, please contact NAHRI at...
The Office of Inspector General (OIG) recently conducted an audit to determine the financial impacts of expanding CMS’ hospital transfer policy for discharges to post-acute care to include all MS-DRGs.
