2024 OPPS proposed rule: Major changes to price transparency requirements, covered services, and reimbursement

Wed, 07/19/2023
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS is doubling down on price transparency compliance and enforcement, according to the 2024 Outpatient Prospective Payment System (OPPS) proposed rule. The proposed rule also details major changes to price transparency requirements and behavioral health reimbursement, coverage of dental services, and more.

2024 MPFS proposed rule expands telehealth and dental coverage, steep cuts to conversion factor

Wed, 07/19/2023
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS is proposing a 3.4% reduction to the Medicare Part B conversion factor in the 2024 Medicare Physician Fee Schedule (MPFS) proposed rule. The agency is also floating expanded telehealth and dental coverage among numerous other changes.

NAHRI Leadership Council Meeting (07-12-23)

Thu, 07/13/2023 - 12:11
Council Resources
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Denials and Appeals, NAHRI Leadership Council, Program Management, Revenue Integrity

Download the July 2023 issue of the NAHRI Journal

Wed, 07/12/2023
NAHRI Journal - Volume 7, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Payer Contracting, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Strengthen your revenue integrity team.

2024 IPPS proposed rule: CMS signals changes for coding and reimbursement

Wed, 07/12/2023
NAHRI Journal - Volume 7, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Take a closer look at how CMS’ proposed payment changes could impact hospital reimbursement and revenue integrity workflows.

Case study: Implementing annual CPT code updates

Wed, 07/12/2023
NAHRI Journal - Volume 7, Issue 3
Chargemaster and Charge Capture, Coding and Documentation, Policies and Procedures, Program Management, Revenue Integrity

Learn how one organization successfully manages cross-functional processes for annual CPT updates.

Selecting the right revenue code

Wed, 07/12/2023
NAHRI Journal - Volume 7, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Ensure compliance and protect revenue by making the right revenue code choices

Defining medical necessity

Wed, 07/12/2023
NAHRI Journal - Volume 7, Issue 3
Coding and Documentation, Compliance, Revenue Integrity

Review requirements for medical necessity and compliant physician orders.

Dispelling confusion on billing for observation services

Wed, 06/21/2023
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, News, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Ronald Hirsch, MD, FACP, CHCQM, CHRI, discusses strategies for complying with payers' rules for observation services.

Comply With CAH Telehealth Reporting Guidelines

Fri, 06/02/2023 - 16:42
Webinars
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Sandy Giangreco Brown, MHA, BS, RHIT, CCS, CCS-P, CHC, COC, CPC, CPC-I, COBGC, PCS, and Jennifer Campbell, CMPE, CPC, CPB, discuss how rural health clinic (RHC) and critical access hospital (CAH) may charge for telehealth services, what documentation is necessary, and more.

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