Q&A: Structuring denials management

Thu, 06/05/2025
Revenue Integrity Insider
Denials and Appeals, Program Management, Revenue Integrity

Q: How is revenue integrity involved in denials management?

Predict, Prioritize, and Prevent for Successful Denials Management

Thu, 06/05/2025 - 09:04
Webinars
Denials and Appeals, Revenue Integrity

Josh Amrhein offers strategies for improving denials management processes.

Reduce Physician E/M Denials with Compliant Modifier -25 Reporting

Tue, 06/03/2025 - 10:03
Webinars
Billing and Claims, Coding and Documentation, Compliance, Denials and Appeals, Revenue Integrity

Betty A. Hovey, BSHAM, CCS-P, CDIP, CPC, COC, CPMA, CPCD, CPB, CPC-I, discusses how to support compliant reporting of modifier -25 and reduce denials.

Recipe for Success: 2025 State of the Revenue Integrity Industry

Mon, 06/02/2025
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Revenue Integrity

Revenue integrity professionals need to understand how new elements in the healthcare industry, from changing regulations to advances in technology

Q&A: Identifying opportunities for expansion

Mon, 06/02/2025
Revenue Integrity Insider
Billing and Claims, Denials and Appeals, Payer Contracting, Policies and Procedures, Program Management, Revenue Integrity

Q: What areas or functions would you like to see your revenue integrity program take a bigger role in?

Exploring the OIG Workplan

Mon, 06/02/2025 - 10:14
Webinars
Billing and Claims, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Reimbursement and Payment Methodologies, Revenue Integrity

Leigh Poland, RHIA, CCS, CDIP, CIC, explains how to use the Office of Inspector General's (OIG) Work Plan to identify internal audit opportunities, shore up reimbursement compliance, and protect revenue.

2025 State of the Revenue Integrity Industry Report

June 2, 2025
Industry Report
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Payer Contracting, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

NAHRI is celebrating the eighth annual Revenue Integrity Week (June 2–6) to acknowledge and raise awareness of revenue integrity professionals’ incredible contributions in the healthcare industry. To further support the goals and mission of revenue integrity and advance the development of...

Study shows higher upcoding rates in outpatient settings

Wed, 05/21/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Denials and Appeals, Monitoring and Audits, News, Revenue Integrity

New findings suggest upcoding is becoming a more common practice in emergency departments, urgent care centers, and physician offices. 

How to respond to commercial payer line item denials

Fri, 05/16/2025
Leadership Council Insider
Billing and Claims, Chargemaster and Charge Capture, Denials and Appeals, NAHRI Leadership Council, Revenue Integrity

When organizations receive a charge denial from a commercial payer, they must weigh their options to determine whether challenging the decision wil

Tackling the Denials Challenge: Smarter Strategies, Stronger Defenses

Wed, 05/14/2025 - 14:06
Council Resources
Denials and Appeals, NAHRI Leadership Council, Policies and Procedures, Program Management, Revenue Integrity

Hospitals aren’t just reacting to denials anymore—they’re redesigning the playbook. As commercial and Medicare Advantage (MA) denials grow more complex, organizations are taking strategic, cross-functional approaches to manage them. Revenue integrity teams are leveraging analytics to detect...

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