Q: Is your organization using AI to support any revenue integrity functions? If so, what has that experience been like? If not, what are some of the barriers to implementing AI?
The following is a tool for determining whether an individual supply item is considered to be “routine” for the purposes of creating a charge on the chargemaster.
After the FDA recently reclassified osteogenesis stimulators as class II devices, claims with certain HCPCS codes should no longer include modifier -KF.
Gain expert insights into the nuances of how CMS' rules affect reimbursement and what revenue integrity can do to protect compliant revenue and adapt to changes.
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.
