OIG study investigates wrongful denials from MAOs

Wed, 05/11/2022
Revenue Integrity Insider
Coverage, Denials and Appeals, Monitoring and Audits, Revenue Integrity

Medicare Advantage Organizations (MAO) sometimes inappropriately delay or deny beneficiaries’ access to medically necessary care, according to a...Read More »

NAHRI Leadership Council Meeting (04-13-22)

Wed, 04/13/2022 - 16:40
Council Resources
Billing and Claims, Coding and Documentation, Compliance, Monitoring and Audits, NAHRI Leadership Council, Program Management, Revenue Integrity

Download the April 2022 issue of the NAHRI Journal

Wed, 04/06/2022
NAHRI Journal - Volume 6, Issue 2
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Find creative solutions to revenue integrity challenges.Read More »

Learning from the experts: Using OIG resources to build an audit plan

Wed, 04/06/2022
NAHRI Journal - Volume 6, Issue 2
Compliance, Monitoring and Audits, Revenue Integrity

Apply these expert tips to boost the effectiveness of your internal audits.Read More »

Download the October 2021 issue of the NAHRI Journal

Wed, 10/06/2021
NAHRI Journal - Volume 5, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Scout ahead for revenue integrity opportunities.Read More »

Denial tracking systems: Asking the right questions

Wed, 10/06/2021
NAHRI Journal - Volume 5, Issue 4
Denials and Appeals, Monitoring and Audits, Revenue Integrity

Use these tips to improve your organization’s denial tracking and management efforts.Read More »

Download the July 2021 issue of the NAHRI Journal

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Monitoring and Audits, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Reach the next level of revenue integrityRead More »

Forming a plan for the dreaded, inevitable audit

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Monitoring and Audits, Program Management, Revenue Integrity

Use these expert tips to improve your audit oversight plan.Read More »

Keeping tabs on compliance with internal audits and monitoring

Wed, 07/07/2021
NAHRI Journal - Volume 5, Issue 3
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Monitoring and Audits, Revenue Integrity

Learn how to use regular internal audits and monitoring to boost compliance in revenue integrity areas.Read More »

Sample Payer Charge Denial Letter

Wed, 04/07/2021 - 09:55
Policies & Procedures
Billing and Claims, Chargemaster and Charge Capture, Monitoring and Audits, Revenue Integrity

Use this sample payer charge denial letter to use as a template when drafting appeal letters.

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