Revenue Integrity

Q: I am facing the challenge of starting a revenue integrity program at my organization. What are some of the most important steps for me to take at the beginning of this process?

A federal appeals court on December 29 rejected the hospital industry’s attempt to block CMS’ price transparency rule, effective January 1, that requires hospitals to disclose standard charges, including payer-specific negotiated rates, for 300 services.

The 2020 calendar year was certainly challenging for revenue integrity professionals, as the novel coronavirus (COVID-19) pandemic stressed the workforce, necessitated new working environments, and led to frequent regulatory updates. Through case studies, news, and analysis in the weekly Revenue Integrity Insider enewsletter and the quarterly NAHRI Journal, NAHRI worked to keep the revenue integrity community informed of all the changes. Let’s take a look back at NAHRI’s most-read stories from 2020.

This has been a year like none other. We’ve faced incredible challenges and tragedies and hospitals in particular will be navigating the lingering effects for some time. As we approach the new year, it’s time to consider what we’ve accomplished this year.

CMS announced December 18 that it will begin auditing hospitals for compliance with the Hospital Price Transparency final rule in January 2021.

NAHRI’s Revenue Integrity Symposium is a fantastic way to network with and learn from revenue integrity professionals from across the country. But have you considered that RIS can also help hone your professional speaking skills? NAHRI is currently seeking healthcare professionals who are willing to throw their hat into the RIS ring and submit proposals for the 2021 symposium. We will gather October 19–20, 2021, in Kissimmee, Florida. 

The 2021 Outpatient Prospective Payment System (OPPS) final rule, released December 2, moves ahead with most of the provisions of the proposed rule. This should come as a relief to hospitals required to implement most of its policies by January 1, 2021.