AMA announces major E/M changes for facility-based services

Wed, 07/13/2022
Revenue Integrity Insider
Coding and Documentation, Compliance, News, Revenue Integrity

The American Medical Association’s (AMA) CPT Editorial Panel recently published changes to its evaluatio and management (E/M) Services Guidelines. The update includes code revisions, additions, and deletions, which are scheduled to take effect January 1, 2023.

Download the July 2022 issue of the NAHRI Journal

Wed, 07/06/2022
NAHRI Journal - Volume 6, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Focus on the people and processes that make revenue integrity work.

Transitioning revenue integrity from an operational reactive to a proactive approach

Wed, 07/06/2022
NAHRI Journal - Volume 6, Issue 3
Chargemaster and Charge Capture, Coding and Documentation, Compliance, Policies and Procedures, Program Management, Revenue Integrity

Anna Santoro, MBA, CCS, CCS-P, RCC, CHRI, shared three steps to a proactive revenue integrity department.

2023 IPPS proposed rule: Changes on the horizon

Wed, 07/06/2022
NAHRI Journal - Volume 6, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Consider how CMS’ proposed changes could affect reimbursement and revenue integrity operations.

Getting to the bottom of inpatient-only list compliance

Wed, 07/06/2022
NAHRI Journal - Volume 6, Issue 3
Coding and Documentation, Compliance, Monitoring and Audits, Revenue Integrity

Use these strategies to protect revenue and strengthen compliance with inpatient-only list requirements.

Proactive processes: Tips for preventing denials and protecting revenue

Wed, 07/06/2022
NAHRI Journal - Volume 6, Issue 3
Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Policies and Procedures, Revenue Integrity

Apply these tips to reduce and prevent common denials due to medical necessity, the three-day payment window, and more.

Unnecessary observation care: As the rules change

Wed, 07/06/2022
NAHRI Journal - Volume 6, Issue 3
Billing and Claims, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Revenue Integrity

Understand how to navigate evolving guidance on observation services and medical necessity.

Critical refresh: CAH and RHC billing compliance

Wed, 07/06/2022
NAHRI Journal - Volume 6, Issue 3
Billing and Claims, Coding and Documentation, Compliance, Coverage, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Brush up on revenue integrity essentials for critical access hospitals and rural health clinics.

Q&A: Staffing for chargemaster

Wed, 06/08/2022
Revenue Integrity Insider
Chargemaster and Charge Capture, Coding and Documentation, Denials and Appeals, Program Management, Revenue Integrity

Q: How is your chargemaster staffed and managed?

2022 State of the Revenue Integrity Industry Survey Report

June 6, 2022
Industry Report
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Payer Contracting, Program Management, Revenue Integrity

NAHRI is hosting the fifth annual Revenue Integrity Week to celebrate the hard work, dedication, and remarkable achievements of revenue integrity professionals across the country. As part of Revenue Integrity Week, NAHRI takes an in-depth look at trends across the industry with the 2021 State of the Revenue Integrity Industry Survey Report. The survey explores the roles and responsibilities of revenue integrity professionals, their backgrounds, and the key functions of the job.

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