Case Study: Establishing a Strong Financial Foundation through a Commitment to Quality

Mon, 03/03/2025 - 14:51
White Papers
Coding and Documentation, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

A Southern healthcare organization struggling with low quality scores, revenue loss, and a declining case mix index (CMI) partnered with AMN Healthcare to implement a clinical documentation integrity (CDI) program, achieving rapid improvements.

Within 90 days, revenue increased by 15.5%,...

CMS publishes January 2025 OPPS update

Wed, 02/19/2025
Revenue Integrity Insider
Coding and Documentation, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS published the January 2025 update of the Outpatient Prospective Payment System (OPPS), which includes changes to skin substitute codes, pass-through devices, and more.

Q&A: Selecting revenue codes for cardiac CT services

Wed, 02/12/2025
Revenue Integrity Insider
Ask NAHRI, Billing and Claims, Coding and Documentation, Reimbursement and Payment Methodologies, Revenue Integrity

Q: How has CMS addressed its erroneous revenue code edits for cardiac CT services, and how should we select revenue codes for cardiac CT now?

Reviewing 2025 CDM updates on the January 2025 NAHRI Quarterly Call

Wed, 02/05/2025
Revenue Integrity Insider
Chargemaster and Charge Capture, Coding and Documentation, News, Reimbursement and Payment Methodologies

Read the latest association news and 2025 charge description master (CDM) updates discussed during the most recent NAHRI Quarterly Call. 

NAHRI Quarterly Call - January 28, 2025

Tue, 01/28/2025 - 15:19
Quarterly Calls
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Reimbursement and Payment Methodologies, Revenue Integrity

Listening to a NAHRI Quarterly Call (free for NAHRI members) qualifies for one CHRI CEU credit upon the completion of the accompanying survey. If you’re a NAHRI member and are interested in presenting on an upcoming NAHRI members-only call, please contact NAHRI at...

Preventing denials for CPAP devices and accessories

Wed, 01/22/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Coverage, Denials and Appeals

Review coverage criteria and documentation tips for continuous positive airway pressure (CPAP) devices and accessories.

Hospital outpatient department E/M level visit calculator for facility charges

Thu, 01/16/2025 - 16:42
Council Resources
Chargemaster and Charge Capture, Coding and Documentation, NAHRI Leadership Council, Revenue Integrity

This sample hospital outpatient department E/M Level visit calculator for facility charges was submitted by 2025 NAHRI Leadership Council member Jaclyn Loewen, CPC, revenue integrity manager at UF Health Shands in Gainesville, Florida.

Download the January 2025 issue of the NAHRI Journal

Wed, 01/15/2025
NAHRI Journal - Volume 9, Issue 1
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

Prepare for a successful year with NAHRI.

Preventing revenue leakage through an effective revenue integrity program

Wed, 01/15/2025
NAHRI Journal - Volume 9, Issue 1
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Revenue Integrity

Michele Bear, DBA, MBA, CHRI, CRCR, CHC, CPC, shares tips on how to prevent revenue leakage.

Unpacking new payment policies in CMS’ 2025 OPPS final rule

Wed, 01/15/2025
NAHRI Journal - Volume 9, Issue 1
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how CMS’ new policies and payments for outpatient services will affect your organization.

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