Denials management is critical for providers facing rising denial rates, especially in medical necessity claims, which can delay cash flow and increase appeal costs.
To maintain financial stability and operational efficiency, healthcare organizations must enhance clinical...
CMS improperly paid hospitals over $79 million for mechanical ventilation claims between 2015 and 2021, according to a recent audit report from the Office of Inspector General (OIG).
Hospitals will need to prepare for a new mandatory bundled payment model and significant changes to coding and billing for certain new technologies, social determinants of health (SDOH), and more, according to the fiscal year (FY) 2025 Inpatient Prospective Payment System (IPPS) final rule.
Listening to a NAHRI Quarterly Call (free for NAHRI members) qualifies for one CHRI CEU credit upon the completion of the accompanying survey. If you’re a NAHRI member and are interested in presenting on an upcoming NAHRI members-only call, please contact NAHRI at...
CMS is considering a significant change to how it pays for certain high-cost radiopharmaceuticals, as well as a sweeping new set of Conditions of Participation (CoPs) aimed at maternal health, and a slew of other changes in the 2025 Outpatient Prospective Payment System (OPPS) proposed rule.
Organizations could see a flood of new codes along with significant changes to the Medicare Shared Savings Program (MSSP) and coverage of telehealth services, according the 2025 Medicare Physician Fee Schedule (MPFS) proposed rule.
