Compliance

District court remands 340B repayment determination to HHS

Wed, 01/25/2023

A federal judge remanded remedy decisions to HHS for its underpayments related to the 340B drug pricing program. After experiencing several key...Read More »

Planning for the end of PHE waivers

Fri, 01/20/2023

Leadership Council Insider

Billing and Claims, Compliance, Monitoring and Audits, NAHRI Leadership Council, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

As we start 2023, one of the biggest questions is the fate of the COVID-19 public health emergency declaration (PHE).Read More »

Download the January 2023 issue of the NAHRI Journal

Wed, 01/18/2023

NAHRI Journal - Volume 7, Issue 1

Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Look ahead to a bright future in revenue integrity.Read More »

Preparing for the end of PHE waivers and facility E/M changes

Wed, 01/18/2023

NAHRI Journal - Volume 7, Issue 1

Billing and Claims, Coding and Documentation, Compliance, Coverage, Program Management, Revenue Integrity

Ronald Hirsch, MD, FACP, CHCQM, CHRI, shares tips for preparing for the end of emergency waivers.Read More »

Weighing gains and losses in the 2023 OPPS final rule

Wed, 01/18/2023

NAHRI Journal - Volume 7, Issue 1

Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how CMS’ changes will affect hospital reimbursement.Read More »

Unlocking key changes in the 2023 MPFS final rule

Wed, 01/18/2023

NAHRI Journal - Volume 7, Issue 1

Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Reimbursement and Payment Methodologies, Revenue Integrity

Ensure you’re complying with new rules for billing and coding.Read More »

No Surprises Act: Good in theory, difficult in practice

Wed, 01/18/2023

NAHRI Journal - Volume 7, Issue 1

Billing and Claims, Compliance, Revenue Integrity

Brush up on hospital compliance requirements with surprise billing rules.Read More »

Selecting the right principal diagnosis

Wed, 01/18/2023

NAHRI Journal - Volume 7, Issue 1

Coding and Documentation, Compliance, Revenue Integrity

Apply these tips to resolve questions on principal diagnosis assignment.Read More »

HHS received more than five times as many IDR submission than anticipated

Wed, 01/18/2023

Revenue Integrity Insider

Compliance, Monitoring and Audits, News

More payers and providers are using the independent dispute resolution (IDR) process than the government anticipated to settle payment for items...Read More »

OIG details top unimplemented recommendations for Medicare Parts A and B

Wed, 12/21/2022

Revenue Integrity Insider

Billing and Claims, Compliance, Monitoring and Audits, News

The Office of Inspector General (OIG) recently released its annual report on solutions to reduce fraud, waste, and abuse in HHS programs. In the...Read More »

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