Denials management continues to be a significant challenge for healthcare organizations in 2021, and beyond. Earlier this year, NAHRI conducted a survey to its Leadership Council on denials management, and 100 leaders,...
Q: How should we bill for trauma activation without pre-hospital notification and how should we capture charges for these services? Do we bundle the charge in with the facility evaluation and management (E/M) code?
Healthcare organizations are looking for better ways to stem the flow of denials, which have been even more challenging to manage in the last year and a half. The pandemic triggered a significant shift to virtual care services and many other changes that impacted billing, claims, and coding...
Finding and addressing the roor causes of coding edits is essential to revenue integrity, but when the issue points back to clinical departments it can often be a challenge to get them on board with change. Use these tips to gain clinical departments' support and implement practical, colloboartive solutions.
Successfully responding to payer charge audits for services billed above room and bed rate can be a challenge. The Cleveland Clinic contracting, compliance, and revenue cycle departments worked together on a project to address this focus.
Speakers and registrants shared tips and insights into revenue integrity hot topics on day one of the 2021 Revenue Integrity Symposium, held virtually August 17–18.
CMS released the fiscal year (FY) 2022 IPPS final rule on Monday, August 2, which finalizes its efforts to cushion the ongoing impact of the COVID-19 pandemic on hospital revenue and resources. Along with payment rate updates, the final rule also repealed the MS-DRG relative weight methodology and hospital cost-reporting requirement finalized in the 2021 IPPS final rule.
Less than a year after CMS finalized the three-year phaseout of the inpatient-only (IPO) list to be completed by 2024, the agency is looking to reverse course, according to the 2022 OPPS proposed rule, released Monday, July 19.
