A closer look at CMS’ proposed CJR-X model

Wed, 04/22/2026
Revenue Integrity Insider
Reimbursement and Payment Methodologies, Billing and Claims, News

Learn more about CMS' plans to launch a nationwide expansion of its Comprehensive Care for Joint Replacement (CJR) model.

How One Health System Strengthened Revenue Integrity and Recovered $17.5M

Tue, 04/14/2026 - 12:02
Free White Papers
Revenue Integrity, Program Management, Billing and Claims, Coding and Documentation

A large multi-state health system stabilized coding operations, cleared major backlogs, and improved financial performance across nearly 70 hospitals.

Results Snapshot

    • $17.5M net revenue gain
    • ...

2027 IPPS proposed rule: Payment updates, expanded CJR model

Wed, 04/15/2026
Revenue Integrity Insider
Revenue Integrity, Reimbursement and Payment Methodologies, Billing and Claims, News, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

CMS is weighing an expansion of the Comprehensive Care for Joint Replacement (CJR) model as well as cuts to disproportionate share hospital (DSH) payments, according to the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule. 

Download the April 2026 issue of the NAHRI Journal

Wed, 04/01/2026
NAHRI Journal - Volume 10, Issue 2
Policies and Procedures, Revenue Integrity, Reimbursement and Payment Methodologies, Program Management, Billing and Claims, Denials and Appeals, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

Learn how to set the stage for your revenue integrity success.

From silos to synergy: Driving DNFB reduction through revenue integrity leadership

Wed, 04/01/2026
NAHRI Journal - Volume 10, Issue 2
Policies and Procedures, Revenue Integrity, Reimbursement and Payment Methodologies, Program Management, Billing and Claims, Chargemaster and Charge Capture

Michael de Armas, MSHIA, CPC, CRCR, CSBI, shares tips for reducing DNFB through revenue integrity leadership.

Learning how to be a TEAM player

Wed, 04/01/2026
NAHRI Journal - Volume 10, Issue 2
Revenue Integrity, Reimbursement and Payment Methodologies, Program Management, Billing and Claims, Coverage, Coding and Documentation

Understand revenue integrity’s role in CMS’ TEAM program.

Download the April 2026 NCCI quarterly edit files

Wed, 03/25/2026
Revenue Integrity Insider
Revenue Integrity, Billing and Claims, News, Coding and Documentation

Revenue integrity professionals should take note of the latest edition of the National Correct Coding Initiative (NCCI) quarterly edit files, which take effect on April 1.

NAHRI Leadership Council Meeting (03-19-26)

Fri, 03/20/2026 - 10:27
Council Resources
Policies and Procedures, Revenue Integrity, Program Management, Payer Contracting, Billing and Claims, Monitoring and Audits, Denials and Appeals, Coverage, Compliance, Coding and Documentation, Chargemaster and Charge Capture

The Council's agenda for the March 19, 2026 meeting was:

•Presentation: How to optimize systems to involve clinicians in denials and use data to drive improvement ―Gopi Astik, MD, MS, medical director, Northwestern Memorial Hospital...

ESRD, AKI billing changes to take effect July 1

Wed, 02/25/2026
Revenue Integrity Insider
Revenue Integrity, Reimbursement and Payment Methodologies, Billing and Claims, News, Coding and Documentation

Review upcoming changes to modifier -AX reporting requirements and other end-stage renal disease (ESRD) and acute kidney injury (AKI) billing instructions.

HIPAA and Revenue Integrity: Beyond PHI

Mon, 02/23/2026 - 16:18
Webinars
Policies and Procedures, Revenue Integrity, Reimbursement and Payment Methodologies, Program Management, Billing and Claims, Denials and Appeals, Compliance, Coding and Documentation, Chargemaster and Charge Capture

During this 60 minute webinar, expert speaker Valerie A. Rinkle, MPA, CHRI, president of Valorize Consulting, LLC, explains HIPAA requirements for chargemaster and the intersection with CMS requirements for uniform charging.

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