AHA: UHC’s new lab test code requirements create unnecessary burden

Wed, 09/16/2020
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Revenue Integrity

UnitedHealthcare’s (UHC) plan to require in-network, freestanding and outpatient laboratory claims to contain a unique code for most lab testing...Read More »

Q&A: Documentation standards for prior authorization

Wed, 08/26/2020
Revenue Integrity Insider
Ask NAHRI, Billing and Claims, Compliance, Coverage, Revenue Integrity

Q: Is there a national standard for what documentation must be submitted to Medicare Administrative Contractors (MAC) when requesting prior...Read More »

CMS will require positive COVID-19 test results for increased inpatient payment

Wed, 08/19/2020
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Reimbursement and Payment Methodologies, Revenue Integrity

Inpatient novel coronavirus (COVID-19) claims will require a positive viral test result to be eligible for the 20% increase in the MS-DRG...Read More »

Note from the Director: NAHRI to host virtual revenue integrity event

Wed, 08/19/2020
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

High-level continued learning and engaged networking with peers are critical to revenue integrity professionals as healthcare regulations...Read More »

CMS releases hospital telemedicine billing decision tree

Wed, 08/12/2020
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, News, Revenue Integrity

CMS’ latest round of updates to its novel coronavirus FAQs on Medicare fee-for-service billing provides additional information on hospital billing...Read More »

Telehealth Services: Some Smooth Sailing, but Still Choppy Waters (July 30)

Submitted by jfitzgerald@hcp... on Thu, 07/30/2020 - 15:47

Telehealth Services: Some Smooth Sailing, but Still Choppy Waters - July 30

Featuring:

Jennie Bryan, MBA, RHIA, CCS, healthcare risk client-based associate manager for Crowe Healthcare Risk Consulting LLC, in Clayton, Missouri

Denise Williams, COC, senior vice president, revenue integrity services, REVANT Solutions, Trussville, Alabama

NAHRI Quarterly Call - July 28, 2020

Tue, 07/28/2020 - 15:21
Quarterly Calls
Billing and Claims, Chargemaster and Charge Capture, Reimbursement and Payment Methodologies, Revenue Integrity

Upcoming calls are scheduled for the following dates and times:

  • Tues, October 27, 2020 1:00 - 2:00 EDT 
  • Tues, January 26, 2021 1:00 - 2:00 EDT
  • Tues, April 27, 2021 1:00 - 2:00 EDT
  • ...

Appeals court upholds CMS’ site-neutral payment policy

Wed, 07/22/2020
Revenue Integrity Insider
Billing and Claims, Reimbursement and Payment Methodologies, Revenue Integrity

An appeals court ruled that CMS has the authority to implement a controversial site-neutral payment policy. The ruling, delivered July 17,...Read More »

How Duke Health structures a dynamic revenue integrity department

Wed, 07/08/2020
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Revenue Integrity

The Duke University Health System in Durham, North Carolina, has more than 1,200 inpatient beds, handles two million outpatient visits annually,...Read More »

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