CMS: Medical necessity errors account for more than 90% of improper payments for routine venipuncture labs

Wed, 02/20/2019
Revenue Integrity Insider
Billing and Claims, Denials and Appeals, News, Revenue Integrity

The improper payment rate for routine venipuncture lab tests was 16.3% in 2018, representing more than $20 million, and medical necessity errors...Read More »

Use benchmarks to stop revenue leakage through small-dollar edits and denials

Wed, 02/13/2019
Revenue Integrity Insider
Billing and Claims, Denials and Appeals, Monitoring and Audits, Revenue Integrity

Learn how to track and evaluate small-dollar denials before they add up to major revenue losses.Read More »

Revenue integrity associate for denial management job description

Fri, 02/08/2019 - 14:56
Job Descriptions
Denials and Appeals, Program Management, Revenue Integrity

Use this sample revenue integrity associate for denial management job description as a template for your facility.

NAHRI news and revenue integrity insights on our latest quarterly call

Wed, 02/06/2019
Revenue Integrity Insider - Volume 3 Issue 5
Chargemaster and Charge Capture, Coding and Documentation, Denials and Appeals, Policies and Procedures, Program Management, Revenue Integrity

On January 29, NAHRI presented its first members-only quarterly call of the year, where members heard from revenue integrity experts on engaging...Read More »

Note from the director: 2019 Revenue Integrity Symposium keynote, location, dates announced

Wed, 01/30/2019
Revenue Integrity Insider - Volume 3 Issue 3
Billing and Claims, Chargemaster and Charge Capture, Denials and Appeals, Revenue Integrity

It’s hard to believe planning for the 2019 Revenue Integrity Symposium (RIS) is already underway. It feels like just yesterday we were all...Read More »

Successful strategies to appeal denials for AKI and ATN

Thu, 01/03/2019
NAHRI Journal - Volume 3 Issue 1
Coding and Documentation, Denials and Appeals, Revenue Integrity

Put these practices into place to overcome clinical validation denials for these services.Read More »

Medicare Advantage proposed rule earns praise, criticism from pharmacy groups and patient advocacy organizations

Thu, 12/13/2018
Revenue Integrity Insider - Volume 2 Issue 31
Coverage, Denials and Appeals, Reimbursement and Payment Methodologies, Revenue Integrity

A proposed rule that would expand the use of prior authorization and step therapy for Part D and Medicare Advantage beneficiaries has earned...Read More »

Note from the speaker: Denial prevention strategies at the 2018 Revenue Integrity Symposium

Tue, 10/09/2018
Revenue Integrity Insider - Volume 2 Issue 24
Denials and Appeals, Revenue Integrity

By Tracey A. Tomak, PMP, RHIA

It’s nearly time to head back to the National Association of Healthcare Revenue Integrity’s 2018...Read More »

OIG: Medicare Advantage overturns 75% of its own claim denials

Wed, 10/03/2018
Revenue Integrity Insider - Volume 2 Issue 25
Billing and Claims, Denials and Appeals, Revenue Integrity

The high volume of successful appeals, particularly on the first level, raises concerns that Medicare Advantage Organizations were denying payment...Read More »

Note from the speaker: Patient status and denials education at the 2018 Revenue Integrity Symposium

Wed, 10/03/2018
Revenue Integrity Insider - Volume 2 Issue 25
Denials and Appeals, Reimbursement and Payment Methodologies, Revenue Integrity

By Ralph Wuebker, MD, MBA

The healthcare revenue cycle is changing at break neck speed. Staying up to date on CMS regulations as...Read More »

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