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 »

2021 MPFS final rule expands telehealth services, finalizes E/M documentation changes

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

The 2021 Medicare Physician Fee Schedule (MPFS) final rule, released December 2, extends certain telehealth benefits but makes cuts to the...Read More »

CMS to allow authorized hospitals to provide inpatient care in patients’ homes

Wed, 12/02/2020
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coverage, News, Revenue Integrity

CMS announced on November 25 that it is building on the flexibilities granted by the Hospitals Without Walls program to launch the Acute Hospital...Read More »

CMS approves additional payment for new COVID-19 treatments, adds price transparency requirements for diagnostic testing

Wed, 11/18/2020
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

The New COVID-19 Treatments Add-on Payment will allow additional Medicare payment for eligible hospital inpatient and outpatient cases that...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 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 »

Revenue integrity experts discuss recent CMS changes, denials management, and remote management at virtual education event

Wed, 10/07/2020
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Coverage, Denials and Appeals, Reimbursement and Payment Methodologies, Revenue Integrity

Revenue integrity experts shared advice and lessons learned over the past months during day one of Revenue Integrity and Reimbursement Strategies...Read More »

Pages