Health systems have heard the case for autonomous coding. What they hear far less about is what happens after go-live: the team conversations, the workflow adjustments, and the months it takes before a new operational rhythm starts to feel normal.
In the latest update to its Vaccine Administration National Fee Schedule, CMS established three Level II Healthcare Common Procedure Coding System (HCPCS) codes for billing a biosimilar used to treat COVID-19.
Accurate DRG reporting is essential to hospital reimbursement, quality measurement, and transparency, making coding professionals a critical link between clinical documentation and reportable outcomes. In...
The Office of Inspector General (OIG) recently conducted an audit to identify potential vulnerabilities in the Medicare program that could be contributing to improper payments for virtual check-in and e-visit services.
Gain insights into how healthcare organizations can modernize the mid-revenue cycle by integrating AI-driven insights, interdepartmental audit programs, and targeted provider education across inpatient, outpatient, and professional settings.
CMS is weighing an expansion of the Comprehensive Care for Joint Replacement (CJR) model as well as cuts to disproportionate share hospital (DSH) payments, according to the fiscal year (FY) 2027 Inpatient Prospective Payment System (IPPS) proposed rule.
On Wednesday, June 3, 1-2 p.m. Eastern, join NAHRI and our panel of revenue integrity leaders and experts to gain insights into how you can set the stage for revenue integrity success! Taking data from NAHRI's 2026 State of the Revenue Integrity Industry Survey, we'll look at current and...
CMS recently issued the calendar year (CY) 2027 Medicare Advantage (MA) and Part D rate announcement, which outlines upcoming changes to payment rates, risk adjustment policies, and more.
