Navigating the 2025 MPFS proposed rule

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Consider how CMS’ proposed changes could impact your organization.

MSSP overhaul

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Catch up on potential changes to the Medicare Shared Savings Program (MSSP).

Staying up to date with NCCI edits

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Coding and Documentation, Compliance, Monitoring and Audits, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Review recent changes and compliance tips for NCCI edits.

DSH payments: Understanding compliance, payment, and opportunities

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Dig deeper into compliance and reimbursement issues for disproportionate share hospitals.

Advocating for change in the 2025 OPPS proposed rule

Fri, 09/20/2024
Leadership Council Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, NAHRI Leadership Council, News, Reimbursement and Payment Methodologies, Revenue Integrity

NAHRI’s comments to CMS on the 2025 OPPS proposed rule

Wed, 09/11/2024
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

NAHRI submitted comments to CMS on several key aspects of the calendar year (CY) 2025 Outpatient Prospective Payment System (OPPS) proposed rule.

NAHRI comments to CMS on the calendar year 2025 Outpatient Prospective Payment System proposed rule

Fri, 09/06/2024 - 20:59
White Papers
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Following is the text of NAHRI's comments to CMS on the proposed changes to the Medicare Outpatient Prospective Payment System and proposed calendar year 2025 rates. Download them below. You may use this letter as a template for submitting your own comments to CMS on any of the topics addressed...

Recent additions to the OIG’s Work Plan

Wed, 09/04/2024
Revenue Integrity Insider
Billing and Claims, Compliance, Monitoring and Audits, News, Revenue Integrity

Revenue integrity professionals should take note of recent additions to the Office of Inspector General’s (OIG) Work Plan.

CMS finalizes TEAM model in FY 2025 IPPS final rule

Wed, 08/14/2024
Revenue Integrity Insider
Compliance, News, Reimbursement and Payment Methodologies, Revenue Integrity

Learn more about the Transforming Episode Accountability Model (TEAM), a new mandatory episode-based payment model set to begin in 2026.

CMS finalizes new payment model, major updates to coding and billing in 2025 IPPS final rule

Wed, 08/07/2024
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

Hospitals will need to prepare for a new mandatory bundled payment model and significant changes to coding and billing for certain new technologies, social determinants of health (SDOH), and more, according to the fiscal year (FY) 2025 Inpatient Prospective Payment System (IPPS) final rule.

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