Medicare made $54.4 million in improper payments to acute care hospitals for post-acute transfers that did not comply with Medicare’s policies,...Read More »
CMS released the 2020 OPPS proposed rule July 29, proposing to refine previous policies related to price transparency and the 2-midnight rule,...Read More »
Payer contract terms have far-reaching consequences, from the types of services covered and the documentation required to how appeals are...Read More »
Facilities need to know how to respond to documentation requests as part of any Medicare audit or review. Preparing a complete and proper reply...Read More »
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is key to revenue integrity success. Understanding its benefits and limits...Read More »
As part of its Patients Over Paperwork initiative, CMS is collecting public input on ways to reduce unnecessary administrative and regulatory...Read More »
In the spirit of Revenue Integrity Week, which is designed to celebrate the diligence and dedication of revenue integrity professionals, NAHRI’s...Read More »
In the spirit of Revenue Integrity Week, which is designed to celebrate the diligence and dedication of revenue integrity professionals, NAHRI’s State of the Revenue Integrity Industry Survey once again took a deep dive into the roles of revenue integrity professionals, the activities they are responsible for, and the backgrounds from which they came. Though many respondents have been performing duties that align with revenue integrity work for upwards of decades, established revenue integrity titles and roles have been around for a shorter period. As we compare results from last year, we can only begin to see a shift as facilities establish departments and programs and further define revenue integrity.
Commercial and government payers track chronic conditions using Hierarchical Condition Category (HCC), and providers can track HCCs to better...Read More »
