Navigating the 2025 MPFS proposed rule

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Consider how CMS’ proposed changes could impact your organization.

Staying up to date with NCCI edits

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Coding and Documentation, Compliance, Monitoring and Audits, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Review recent changes and compliance tips for NCCI edits.

CMS issues revenue code fix for cardiac CT services

Wed, 10/02/2024
Revenue Integrity Insider
Billing and Claims, News, Reimbursement and Payment Methodologies, Revenue Integrity

After receiving responses to a recent request for information, CMS issued a revenue code fix for cardiac CT services.

2024 ACDIS/NAHRI Denials Management Mastermind Recap

Thu, 09/26/2024 - 09:14
Webinars
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Denials and Appeals, Monitoring and Audits, NAHRI Leadership Council, Policies and Procedures, Revenue Integrity

Healthcare organizations are under more and more pressure from denials, impacting hospitals’ bottom lines and ultimately resources they have available to care for patients. Those in the revenue integrity and clinical documentation integrity (CDI) fields are

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CMS releases OPPS, NCCI updates

Wed, 09/25/2024
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, News, Reimbursement and Payment Methodologies, Revenue Integrity

Review recent updates to the Outpatient Prospective Payment System (OPPS) and National Correct Coding Initiative (NCCI) edit files.

Advocating for change in the 2025 OPPS proposed rule

Fri, 09/20/2024
Leadership Council Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, NAHRI Leadership Council, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS updates COVID-19 vaccine prices for 2024-2025 season

Wed, 09/18/2024
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, News, Revenue Integrity

CMS recently updated prices for certain Novavax, Pfizer-BioNTech, and Moderna COVID-19 vaccines for the 2024-2025 season.

NAHRI’s comments to CMS on the 2025 OPPS proposed rule

Wed, 09/11/2024
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

NAHRI submitted comments to CMS on several key aspects of the calendar year (CY) 2025 Outpatient Prospective Payment System (OPPS) proposed rule.

NAHRI comments to CMS on the calendar year 2025 Outpatient Prospective Payment System proposed rule

Fri, 09/06/2024 - 20:59
White Papers
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Following is the text of NAHRI's comments to CMS on the proposed changes to the Medicare Outpatient Prospective Payment System and proposed calendar year 2025 rates. Download them below. You may use this letter as a template for submitting your own comments to CMS on any of the topics addressed...

Recent additions to the OIG’s Work Plan

Wed, 09/04/2024
Revenue Integrity Insider
Billing and Claims, Compliance, Monitoring and Audits, News, Revenue Integrity

Revenue integrity professionals should take note of recent additions to the Office of Inspector General’s (OIG) Work Plan.

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