Denials and Appeals

Improve your appeal strategy with an eye on facts and compliance.

Adirondack Health came to TruBridge after discovering they could save money over their previous clearinghouse. Due to the seamless integration to Meditech as well as other product capabilities, the several benefits revealed themselves.

Learn how to standardize and coordinate payer audit responses across your organization.

NAHRI is currently accepting applications for its Advisory Board. Taking an active role in NAHRI can set you on the path to shape the future of the revenue integrity profession as well as advance your career. Applications are open to current or future NAHRI members and have been extended through March 9, 2020. 

by Jaclyn Fitzgerald, CHRI

The National Association of Healthcare Revenue Integrity Professionals (NAHRI) is currently accepting applications for its Advisory Board. Taking an active role in NAHRI can set you on the path to shape the future of the revenue integrity profession as well as advance your career. Applications are open to current or future NAHRI members and have been extended through March 9, 2020. 

Planning is underway for the Fifth Annual Revenue Integrity Symposium, and this is one event you won’t want to miss taking an active role in. This year, we gather October 6–7, 2020, in Westminster (Denver), Colorado. RIS is NAHRI’s national conference—your chance to gather with likeminded professionals from across the country to make lasting connections while learning the latest strategies to excel in your career. And what better way to showcase your passion for revenue integrity and your ever-evolving skillset than getting up on stage and presenting to an audience of your peers.

CMS released the 2020 OPPS proposed rule July 29, proposing to refine previous policies related to price transparency and the 2-midnight rule, moving forward with year two of the site-neutral payment policy for clinic visits, while also asking for comments on how to potentially undo its policy that reduced payments for drugs purchased under the 340B drug discount program by nearly 30%.

Payer contract terms have far-reaching consequences, from the types of services covered and the documentation required to how appeals are negotiated. Learn how revenue integrity can collaborate with physician advisors to monitor and address problems with payer contracts.

As part of its Patients Over Paperwork initiative, CMS is collecting public input on ways to reduce unnecessary administrative and regulatory burden.