Denials are a constant thorn for healthcare organizations, and are often caused by factors outside of an organization’s control, such as to new payer rules or patients switching medical plans. When left unchecked, claim denials can represent an average loss of up to 5% of net patient revenue.

Accurate revenue code selection affects concerns central to revenue integrity and the operations of healthcare provider organizations such as compliance and reimbursement. In this white paper, NAHRI Advisory Board Valerie Rinkle, MPA, CHRI, explains the importance of accurate revenue code...

 In this position paper, the NAHRI Advisory Board breaks down the steps involved in writing and submitting comments on proposed rules and policy changes and discusses why this activity is essential for revenue integrity professionals.

An estimated 1% of net revenue is lost every year due to incorrect or incomplete coding—costing hospitals millions of dollars annually.
 
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The 2022 NAHRI Leadership Council Survey Part 2 examines claim edit patterns, pre-billing processes, and top payer trends.

In addition to clinical areas, the last two years of the COVID-19 pandemic also introduced massive disruption to the revenue cycle, skewing billing processes and...

Despite investments in both technology and people, clean claim submission that reflects optimized compliant revenue capture still eludes most healthcare organizations. This...

NAHRI Leadership Council shares best practices, resolving top challenges, and working around staffing shortages.

In the 2022 NAHRI Leadership Council survey: Custom Edits—Creation and Workflow, 100 leaders, including revenue integrity, health information management (HIM), and coding...

With thousands of Medicare patients discharged to post-acute care facilities annually, hospitals need to identify claims that failed to transfer under Medicare’s Post-Acute Care Transfer rules....

Optimized financial performance starts with accurately coded claims, yet far too many providers only review a small portion of cases prior to billing. This means the majority of the issues behind revenue leakage...

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