CMS retracts audit determinations for certain provider-based departments

Wed, 09/29/2021
Revenue Integrity Insider
Billing and Claims, Compliance, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS is rescinding audit determinations for off-campus provider-based departments that claimed the mid-build exception under the 21st Century Cures Act,

Smart revenue integrity: Using automation to manage payer requirements

Wed, 09/22/2021
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Revenue Integrity

Learn how one organization has used automation to improve charge capture and get clean claims out the door faster.

Report: The Crucial Role of Technology and Provider Engagement in Reducing Denials

Thu, 09/16/2021 - 11:34
Council Resources
Billing and Claims, Coding and Documentation, Denials and Appeals, NAHRI Leadership Council, Revenue Integrity

2021 NAHRI Council Survey Part 2 explores best practices for leveraging technology, automation, and clinical collaboration. 

Report: Closing Critical Gaps in Denials Management

Thu, 09/16/2021 - 11:31
Council Resources
Billing and Claims, Coding and Documentation, Denials and Appeals, NAHRI Leadership Council, Revenue Integrity

NAHRI Leadership Council reveals training, process, and technology innovations are driving better outcomes.

CMS revises deadline for reprocessing certain provider-based department claims

Wed, 09/15/2021
Revenue Integrity Insider
Billing and Claims, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS will begin reprocessing 2019 claims for some services rendered at excepted off-campus provider-based departments. The affected claims are for services represented by HCPCS code G0463 (hospital outpatient clinic visit for assessment and management of a patient) with dates of service between January 1, 2019, and December 31, 2019.

NAHRI Leadership Council Meeting (09-10-21)

Fri, 09/10/2021 - 15:04
Council Resources
NAHRI Leadership Council, Program Management, Revenue Integrity

CMS expands Medicare payments for at-home COVID-19 vaccinations

Wed, 09/08/2021
Revenue Integrity Insider
Billing and Claims, News, Revenue Integrity

CMS is expanding payments for at-home COVID-19 vaccinations to include communal spaces in multi-unit living settings or communal arrangements.

Q&A: Capturing trauma activation charges

Wed, 09/01/2021
Revenue Integrity Insider
Ask NAHRI, Billing and Claims, Chargemaster and Charge Capture, Revenue Integrity

Q: How should we bill for trauma activation without pre-hospital notification and how should we capture charges for these services? Do we bundle the charge in with the facility evaluation and management (E/M) code?

Pages