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.
Facilities need to know how to respond to documentation requests as part of any Medicare audit or review. Preparing a complete and proper reply makes all the difference in the outcome or results of those audits and reviews.
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is key to revenue integrity success. Understanding its benefits and limits is important for any successful revenue integrity program.
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.
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 monitor and project reimbursement and compliance.
