2021 OPPS final rule starts the clock on inpatient-only elimination, adds services to prior authorization list

Wed, 12/09/2020
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

The 2021 Outpatient Prospective Payment System (OPPS) final rule, released December 2, moves ahead with most of the provisions of the proposed...Read More »

UHC lab test code requirement delayed

Wed, 12/02/2020
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, News, Revenue Integrity

United Healthcare (UHC) recently announced that it is delaying the implementation date of its unique laboratory code policy. The policy, which was...Read More »

Final check: Last minute tips for price transparency

Wed, 11/04/2020
Revenue Integrity Insider
Chargemaster and Charge Capture, Compliance, Revenue Integrity

The deadline to comply with CMS’ expanded price transparency requirements is almost here. Use these tips to ensure your organization is ready.Read More »

CMS launches Hospital Price Transparency website for hospitals and patients

Wed, 10/21/2020
Revenue Integrity Insider
Chargemaster and Charge Capture, Compliance, Revenue Integrity

CMS recently launched a Hospital Price Transparency website to help hospitals prepare to comply with price transparency requirements effective...Read More »

Download the October 2020 issue of the NAHRI Journal

Wed, 10/14/2020
NAHRI Journal - Volume 4, Issue 4
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

Put revenue integrity into focus to manage year end changes and ongoing challenges.Read More »

2021 OPPS proposed rule: Major proposals could be a mixed bag for hospitals

Wed, 10/14/2020
NAHRI Journal - Volume 4, Issue 4
Billing and Claims, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Unravel the major proposed changes, including elimination of the inpatient-only list and expanded prior authorization requirements.Read More »

2021 MPFS proposed rule: Payment fluctuations and telehealth changes on the horizon

Wed, 10/14/2020
NAHRI Journal - Volume 4, Issue 4
Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how major changes to reimbursement and the future of telehealth services could affect your organization.Read More »

2021 OPPS and MPFS Q&A

Wed, 10/14/2020
NAHRI Journal - Volume 4, Issue 4
Coding and Documentation, Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Revenue integrity experts and NAHRI Advisory Board members dig into the nuances of the proposed rules.Read More »

2021 IPPS final rule finalizes shifts to market-based MS-DRG methodology

Wed, 10/14/2020
NAHRI Journal - Volume 4, Issue 4
Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Review the final requirements effective October 1 and ensure your organization is in compliance.Read More »

Modifier -CS: Clarity and confusion

Wed, 10/14/2020
NAHRI Journal - Volume 4, Issue 4
Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Take a look at CMS’ recent guidance on the use of this modifier and how to navigate lingering questions.Read More »

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