2022 MPFS proposed rule: Conversion factor cut, telehealth and AUC updates

Wed, 07/14/2021
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS is proposing a 4% decrease to the Medicare conversion factor, permanent expansion of telehealth coverage for some mental health services, and...Read More »

HHS: New rule limits balance billing, creates processes for calculating out-of-network payment for emergency services

Wed, 07/07/2021
Revenue Integrity Insider
Billing and Claims, Compliance, News, Revenue Integrity

Balance billing for emergency services and certain other services will be subject to new limitations, according to an interim final rule with...Read More »

Download the July 2021 issue of the NAHRI Journal

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

Reach the next level of revenue integrityRead More »

Medicare prior authorization: Understanding and applying CMS updates

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

Brush up on the most recent changes to Medicare’s prior authorization requirements and their operational impact.Read More »

Connecting the dots: Revenue integrity and utilization review

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

Consider how revenue integrity and utilization review teams can work together to meet shared goals.Read More »

In the balance: Weighing the benefits of self-denial and condition code 44

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

Gain a fresh perspective on methods to efficiently address patient status changes.Read More »

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.Read More »

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.Read More »

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...Read More »

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...Read More »

Pages