Revenue Integrity Insider

2024 OPPS proposed rule: Major changes to price transparency requirements, covered services, and reimbursement

Wednesday, July 19, 2023
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

CMS is doubling down on price transparency compliance and enforcement, according to the 2024 Outpatient Prospective Payment System (OPPS) proposed rule. The proposed rule also details major changes to price transparency requirements and behavioral health reimbursement, coverage of dental...Read More »

NAHRI Journal - Volume 7, Issue 3

2024 IPPS proposed rule: CMS signals changes for coding and reimbursement

Wednesday, July 12, 2023
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Take a closer look at how CMS’ proposed payment changes could impact hospital reimbursement and revenue integrity workflows.Read More »

NAHRI Journal - Volume 7, Issue 3

Case study: Implementing annual CPT code updates

Wednesday, July 12, 2023
Chargemaster and Charge Capture, Coding and Documentation, Policies and Procedures, Program Management, Revenue Integrity

Learn how one organization successfully manages cross-functional processes for annual CPT updates.Read More »

NAHRI Journal - Volume 7, Issue 3

Download the July 2023 issue of the NAHRI Journal

Wednesday, July 12, 2023
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Payer Contracting, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Strengthen your revenue integrity team.Read More »

NAHRI Journal - Volume 7, Issue 3

Defining medical necessity

Wednesday, July 12, 2023
Coding and Documentation, Compliance, Revenue Integrity

Review requirements for medical necessity and compliant physician orders.Read More »

NAHRI Journal - Volume 7, Issue 3

Selecting the right revenue code

Wednesday, July 12, 2023
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Ensure compliance and protect revenue by making the right revenue code choicesRead More »

Revenue Integrity Insider

Dispelling confusion on billing for observation services

Wednesday, June 21, 2023
Billing and Claims, Coding and Documentation, Compliance, News, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Ronald Hirsch, MD, FACP, CHCQM, CHRI, discusses strategies for complying with payers' rules for observation services.Read More »

Revenue Integrity Insider

CMS updates FAQ on PHE waivers and flexibilities

Wednesday, May 24, 2023
Billing and Claims, Coding and Documentation, Compliance, News, Policies and Procedures, Revenue Integrity

CMS recently updated an FAQ to clarify outpatient therapy and telehealth billing policies after the PHE conclusion.Read More »

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