AHA report details MA plans’ impact on rural hospitals

Wed, 02/26/2025
Revenue Integrity Insider
Denials and Appeals, News, Reimbursement and Payment Methodologies, Revenue Integrity

The American Hospital Association (AHA) released a report to highlight how Medicare Advantage (MA) organizations create increased administrative and financial burdens for rural hospitals.

Preventing denials for CPAP devices and accessories

Wed, 01/22/2025
Revenue Integrity Insider
Billing and Claims, Coding and Documentation, Coverage, Denials and Appeals

Review coverage criteria and documentation tips for continuous positive airway pressure (CPAP) devices and accessories.

Download the January 2025 issue of the NAHRI Journal

Wed, 01/15/2025
NAHRI Journal - Volume 9, Issue 1
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

Prepare for a successful year with NAHRI.

Preventing revenue leakage through an effective revenue integrity program

Wed, 01/15/2025
NAHRI Journal - Volume 9, Issue 1
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Revenue Integrity

Michele Bear, DBA, MBA, CHRI, CRCR, CHC, CPC, shares tips on how to prevent revenue leakage.

Untangling the web of denials and differing diagnostic standards

Wed, 01/15/2025
NAHRI Journal - Volume 9, Issue 1
Coding and Documentation, Denials and Appeals, Revenue Integrity

Take a closer look at the role diagnostic standards play in denials and how to improve processes.

Tracking denials: Collect the right data

Wed, 01/15/2025
NAHRI Journal - Volume 9, Issue 1
Denials and Appeals, Revenue Integrity

Ensure you’re monitoring the right data for denials management.

Mastering denials management: Strategic insights for revenue cycle leaders

Fri, 11/15/2024
Leadership Council Insider
Coding and Documentation, Denials and Appeals, NAHRI Leadership Council, Revenue Integrity

by Alba Kuqi, MD, MSHIM, RHIA, CCM, CRCR, CICA, CSMC, CSAF, CCS, CCDS, CDIP

Sample appeal letter: Exhaustion of infertility benefits

Fri, 11/15/2024 - 10:12
Council Resources
Denials and Appeals, NAHRI Leadership Council, Revenue Integrity

This sample appeal letter appealing exhaustion of infertility benefits was submitted by 2024 NAHRI Leadership Council member Brittanie Smiddy, A.S., CPC, CHRI,
CRCR, Revenue Integrity Supervisor at Confluence Health in Washington.

Sample appeal letter: Cardiac catheterization procedure

Fri, 11/15/2024 - 10:07
Council Resources
Denials and Appeals, NAHRI Leadership Council, Revenue Integrity

This sample appeal letter appealing a denial of a cardiac catheterization procedure was submitted by 2024 NAHRI Leadership Council member Brittanie Smiddy, A.S., CPC, CHRI,
CRCR, Revenue Integrity Supervisor at Confluence Health in Washington.

Sample appeal letter: Injection

Fri, 11/15/2024 - 10:03
Council Resources
Denials and Appeals, NAHRI Leadership Council, Revenue Integrity

This sample appeal letter appealing a denial of an injection of a medication was submitted by 2024 NAHRI Leadership Council member Brittanie Smiddy, A.S., CPC, CHRI,
CRCR, Revenue Integrity Supervisor at Confluence Health in Washington.

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