Condition code case studies

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Compliance, Revenue Integrity

Consider these case studies to understand how to apply condition codes 44 and W2.

Keeping tabs on compliance with internal audits and monitoring

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Monitoring and Audits, Revenue Integrity

Learn how to use regular internal audits and monitoring to boost compliance in revenue integrity areas.

CMS increases at-home COVID-19 vaccine payment rate, HHS issues billing reminder

Fri, 06/18/2021
Leadership Council Insider
Billing and Claims, NAHRI Leadership Council, Reimbursement and Payment Methodologies, Revenue Integrity

CMS announced an increase in Medicare payment for at-home administration of COVID-19 vaccines. Medicare will now pay $75 per at-home dose, nearly double its previous $40 adminitration rate.

CMS raises some COVID-19 vaccine payments as HHS issues reminder of billing rules

Wed, 06/16/2021
Revenue Integrity Insider
Billing and Claims, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

CMS boosted Medicare payment for COVID-19 vaccines administered in the patient’s home to $75 per dose, the agency announced June 9. Prior to June 9, Medicare paid $40 per dose for COVID-19 vaccines administered in the patient’s home.

High-cost novel cell and gene therapies: The time for action is now!

Fri, 06/11/2021
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, Revenue Integrity

Jugna J. Shah, MPH, CHRI, discusses why innovative therapies and technologies call for innovations in existing coding, billing, and reimbursement models.

Line item removal of cardiac implants: Revenue integrity’s next challenge

Wed, 06/09/2021
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Compliance, Coverage, Revenue Integrity

Ronald Hirsch, MD, FACP, CHCQM, CHRI, examines recent changes to commercial payer prior authorization requirements and how it affects revenue integrity.

Secrets to Successful New Technology Billing under Medicare’s OPPS and IPPS

Thu, 06/03/2021 - 13:11
Webinars
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Reimbursement and Payment Methodologies, Revenue Integrity

NAHRI Advisory Board member John Settlemyer, MBA, MHA, CPC, CHRI, will walk attendees through the coding and billing processes for new technology in both inpatient and outpatient settings.

Appropriate Use Criteria: Understanding the Requirements and Impact

Thu, 06/03/2021 - 11:57
Webinars
Billing and Claims, Coding and Documentation, Compliance, Revenue Integrity

NAHRI Advisory Board member Denise Williams, COC, CHRI, discusses AUC reporting requirements, how to access the criteria, processes to support reporting, and how to ensure that all information is available and reported on the claim.

Q&A: 2022 IPPS proposed rule

Tue, 05/25/2021
Revenue Integrity Insider
Billing and Claims, Reimbursement and Payment Methodologies

The following is an excerpt from the May 20 episode of The Revenue Integrity Show: A NAHRI Podcast in which we covered the 2022 IPPS proposed rule with guest Jugna Shah, MPH, CHRI, President, Nimitt Consulting Inc., in Spicer, Minnesota.

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