Developing reports using claim edit and denial data

Fri, 10/21/2022
Leadership Council Insider
Billing and Claims, Denials and Appeals, Monitoring and Audits, NAHRI Leadership Council, Revenue Integrity

It’s helpful to understand payer-specific contract terms and government billing requirements when developing work lists or work queues and reports.

OIG to audit CMS for price transparency enforcement

Wed, 10/19/2022
Revenue Integrity Insider
Compliance, Monitoring and Audits, News

The Office of Inspector General (OIG) recently announced it will audit CMS’ monitoring and enforcement of the Hospital Price Transparency final rule. The report is expected for release in 2023.

Download the October 2022 issue of the NAHRI Journal

Wed, 10/05/2022
NAHRI Journal - Volume 6, Issue 4
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

Reach your destination by planning for revenue integrity success.

OIG: Certain telehealth billing practices are a high risk to Medicare

Wed, 09/28/2022
Revenue Integrity Insider
Billing and Claims, Monitoring and Audits

The Office of Inspector General (OIG) recently released an audit report on Medicare integrity risks related to billing for telehealth services during the first year of the COVID-19 pandemic. Although the OIG identified only a small portion of high-risk providers, it acknowledged the need for additional oversight as telehealth continues to grow in popularity.

Q&A: Establishing a proactive auditing and monitoring plan

Wed, 09/21/2022
Revenue Integrity Insider
Ask NAHRI, Monitoring and Audits, Program Management, Revenue Integrity

Q: Which departments can help in the auditing process, and what are their roles?

NAHRI Leadership Council Meeting (07-13-22)

Wed, 07/13/2022 - 16:36
Council Resources
Billing and Claims, Coding and Documentation, Compliance, Monitoring and Audits, NAHRI Leadership Council, Program Management, Revenue Integrity

Download the July 2022 issue of the NAHRI Journal

Wed, 07/06/2022
NAHRI Journal - Volume 6, Issue 3
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

Focus on the people and processes that make revenue integrity work.

Getting to the bottom of inpatient-only list compliance

Wed, 07/06/2022
NAHRI Journal - Volume 6, Issue 3
Coding and Documentation, Compliance, Monitoring and Audits, Revenue Integrity

Use these strategies to protect revenue and strengthen compliance with inpatient-only list requirements.

Uncover the ways that you can prepare for audit activity

Wed, 07/06/2022
Revenue Integrity Insider
Denials and Appeals, Monitoring and Audits, Revenue Integrity

Diane Weiss, CPC, CPB, CCP, CHRI, looks at trends in payer audit activity.

2022 State of the Revenue Integrity Industry Survey Report

June 6, 2022
Industry Report
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Denials and Appeals, Monitoring and Audits, Payer Contracting, Program Management, Revenue Integrity

NAHRI is hosting the fifth annual Revenue Integrity Week to celebrate the hard work, dedication, and remarkable achievements of revenue integrity professionals across the country. As part of Revenue Integrity Week, NAHRI takes an in-depth look at trends across the industry with the 2021 State of the Revenue Integrity Industry Survey Report. The survey explores the roles and responsibilities of revenue integrity professionals, their backgrounds, and the key functions of the job.

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