2022 OPPS proposed rule: CMS increases price transparency penalties, backs off from eliminating inpatient-only list

Wed, 07/21/2021
Revenue Integrity Insider
Billing and Claims, Compliance, News, Reimbursement and Payment Methodologies, Revenue Integrity

Less than a year after CMS finalized the three-year phaseout of the inpatient-only (IPO) list to be completed by 2024, the agency is looking to...Read More »

HHS: New rule limits balance billing, creates processes for calculating out-of-network payment for emergency services

Wed, 07/07/2021
Revenue Integrity Insider
Billing and Claims, Compliance, News, Revenue Integrity

Balance billing for emergency services and certain other services will be subject to new limitations, according to an interim final rule with...Read More »

Download the July 2021 issue of the NAHRI Journal

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Reach the next level of revenue integrityRead More »

Medicare prior authorization: Understanding and applying CMS updates

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Compliance, Coverage, Revenue Integrity

Brush up on the most recent changes to Medicare’s prior authorization requirements and their operational impact.Read More »

Connecting the dots: Revenue integrity and utilization review

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Compliance, Program Management, Revenue Integrity

Consider how revenue integrity and utilization review teams can work together to meet shared goals.Read More »

In the balance: Weighing the benefits of self-denial and condition code 44

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Compliance, Revenue Integrity

Gain a fresh perspective on methods to efficiently address patient status changes.Read More »

Condition code case studies

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Compliance, Revenue Integrity

Consider these case studies to understand how to apply condition codes 44 and W2.Read More »

Keeping tabs on compliance with internal audits and monitoring

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Monitoring and Audits, Revenue Integrity

Learn how to use regular internal audits and monitoring to boost compliance in revenue integrity areas.Read More »

Study: Majority of hospitals fail to meet CMS’ price transparency requirements

Wed, 06/23/2021
Revenue Integrity Insider
Chargemaster and Charge Capture, Compliance, News, Revenue Integrity

Most hospitals are noncompliant with CMS’ Hospital Price Transparency final rule, according to a study published June 14 in JAMA. Out of...Read More »

CMS raises some COVID-19 vaccine payments as HHS issues reminder of billing rules

Wed, 06/16/2021
Revenue Integrity Insider
Billing and Claims, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

CMS boosted Medicare payment for COVID-19 vaccines administered in the patient’s home to $75 per dose, the agency announced June 9. Prior to June...Read More »

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