2024 MPFS proposed rule expands telehealth and dental coverage, steep cuts to conversion factor

Wed, 07/19/2023
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS is proposing a 3.4% reduction to the Medicare Part B conversion factor in the 2024 Medicare Physician Fee Schedule (MPFS) proposed rule. The agency is also floating expanded telehealth and dental coverage among numerous other changes.

Price transparency compliance tied to potential of increased penalties

Wed, 07/12/2023
Revenue Integrity Insider
Compliance, News, Policies and Procedures, Revenue Integrity

Hospitals have made significant efforts to comply with price transparency regulations due to increased civil monetary penalties from CMS, according to a recent JAMA Network Open study.

Download the July 2023 issue of the NAHRI Journal

Wed, 07/12/2023
NAHRI Journal - Volume 7, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Payer Contracting, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Strengthen your revenue integrity team.

2024 IPPS proposed rule: CMS signals changes for coding and reimbursement

Wed, 07/12/2023
NAHRI Journal - Volume 7, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Take a closer look at how CMS’ proposed payment changes could impact hospital reimbursement and revenue integrity workflows.

Selecting the right revenue code

Wed, 07/12/2023
NAHRI Journal - Volume 7, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Ensure compliance and protect revenue by making the right revenue code choices

Defining medical necessity

Wed, 07/12/2023
NAHRI Journal - Volume 7, Issue 3
Coding and Documentation, Compliance, Revenue Integrity

Review requirements for medical necessity and compliant physician orders.

The Importance of Accurate Revenue Code Selection

Wed, 07/05/2023 - 14:32
White Papers
Billing and Claims, Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Accurate revenue code selection affects concerns central to revenue integrity and the operations of healthcare provider organizations such as compliance and reimbursement. In this white paper, NAHRI Advisory Board Valerie Rinkle, MPA, CHRI, explains the importance of accurate revenue code...

Senators request stakeholder feedback on 340B drug pricing program

Wed, 06/28/2023
Revenue Integrity Insider
Compliance, News, Reimbursement and Payment Methodologies, Revenue Integrity

A group of senators recently sent a letter to stakeholders to seek input on improving the 340B drug pricing program.

Dispelling confusion on billing for observation services

Wed, 06/21/2023
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Compliance, News, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Ronald Hirsch, MD, FACP, CHCQM, CHRI, discusses strategies for complying with payers' rules for observation services.

2023 State of the Revenue Integrity Industry Survey Report

June 2, 2023
Industry Report
Billing and Claims, Chargemaster and Charge Capture, Compliance, Denials and Appeals, Monitoring and Audits, Payer Contracting, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

NAHRI is celebrating the sixth annual Revenue Integrity Week (June 5–9) to acknowledge and raise awareness of the invaluable contributions of revenue integrity professionals in the healthcare industry. With the 2023 State of the Revenue Integrity Industry Survey Report, NAHRI is taking an in-...

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