Compliance

Discover how a strong coding audit program can enhance revenue integrity.

The 2020 calendar year was certainly challenging for revenue integrity professionals, as the novel coronavirus (COVID-19) pandemic stressed the workforce, necessitated new working environments, and led to frequent regulatory updates. Through case studies, news, and analysis in the weekly Revenue Integrity Insider enewsletter and the quarterly NAHRI Journal, NAHRI worked to keep the revenue integrity community informed of all the changes. Let’s take a look back at NAHRI’s most-read stories from 2020.

CMS announced December 18 that it will begin auditing hospitals for compliance with the Hospital Price Transparency final rule in January 2021.

The 2021 Outpatient Prospective Payment System (OPPS) final rule, released December 2, moves ahead with most of the provisions of the proposed rule. This should come as a relief to hospitals required to implement most of its policies by January 1, 2021.

United Healthcare (UHC) recently announced that it is delaying the implementation date of its unique laboratory code policy. The policy, which was originally set to go into effect January 1, 2021, will be delayed until January 1, 2022.

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

CMS recently launched a Hospital Price Transparency website to help hospitals prepare to comply with price transparency requirements effective January 1, 2021. Review the latest requirements to ensure your organization is ready to comply and learn about CMS' plans for monitoring and enforcement.

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

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