CMS is seeking comments on a proposed coverage with evidence development for chimeric antigen receptor T-cell (CAR-T) therapy for relapsed or refractory cancer when prescribed by the treating oncologist.
With healthcare costs on the rise, patients are experiencing greater out-of-pocket expenses and providers, in turn, are having difficulty collecting revenue from patients-- a process...
A proposed rule that would expand the use of prior authorization and step therapy for Part D and Medicare Advantage beneficiaries has earned criticism from patient advocacy groups and praise from pharmacy groups.
Revenue integrity professionals often run across tough questions. On the NAHRI Forums, revenue integrity professionals can get advice from peers and experts and learn about solutions others have discovered. Here are the questions that have sparked the most conversation.
Q: When a physician schedules a procedure, do you evaluate the patient’s record prior to the procedure to determine whether all of the coverage requirements of the applicable National Coverage Determinations and/or Local Coverage Determinations are met?
