Hospitals aren’t just reacting to denials anymore—they’re redesigning the playbook. As commercial and Medicare Advantage (MA) denials grow more complex, organizations are taking strategic, cross-functional approaches to manage them. Revenue integrity teams are leveraging analytics to detect...
The Office of Inspector General (OIG) highlighted several congressional actions that, if taken, could lead to $17 billion in potential cost savings across HHS programs.
CMS recently published the April 2025 Outpatient Prospective Payment System (OPPS) update to highlight coding changes for skin substitute products that took effect on April 1.
Listening to a NAHRI Quarterly 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...
Q: If a provider documents sepsis with acute kidney injury but does not explicitly link the two conditions, should they be queried to prevent the claim from being denied?
