July 2025 OPPS update includes vaccine, skin substitute coding changes

Wed, 07/09/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS released the July 2025 update of the Outpatient Prospective Payment System (OPPS) to communicate coding and billing changes that took effect on July 1.

Download the July 2025 issue of the NAHRI Journal

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Payer Contracting, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Get connected to your revenue integrity network.

The critical role of collaboration between revenue integrity and managed care contracting

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Denials and Appeals, Monitoring and Audits, Payer Contracting, Program Management, Revenue Integrity

Irene Sachakov, CHRI, CRCR, CSPR, CSAF, discusses the critical role of collaboration between revenue integrity and managed care contracting.

Change ahead: Understanding the implications of the 2026 IPPS proposed rule

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Gain insights into the potential impact of proposed changes to hospital reimbursement.

New Medicare appeal process: Financial implications abound

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Revenue Integrity

Navigate the complexities of CMS’ newest appeal process.

Preparing for the telehealth policy cliff

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Understand the latest telehealth billing and coding rules.

Building a CPT coding foundation for mental health services

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Coding and Documentation, Compliance, Revenue Integrity

Apply these expert tips to improve billing and coding for behavioral health claims.

Ensuring appropriate coding and documentation for skin substitute claims

Wed, 07/09/2025
NAHRI Journal - Volume 9, Issue 3
Billing and Claims, Coding and Documentation, Compliance, Coverage, Revenue Integrity

Ensure your organization is in compliance with coding and documentation requirements for skin substitute claims.

CMS launches new model to test prior authorization improvements

Wed, 07/02/2025
Revenue Integrity Insider
Billing and Claims, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS recently announced it will partner with companies specializing in enhanced technologies to test improvements to prior authorization processes via a new Innovation Center model.

CMS publishes 2025 Q3 update for NCCI edit files

Wed, 06/18/2025
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, News

CMS posted the third quarter National Correct Coding Initiative (NCCI) edit files, which will take effect on July 1. 

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