Page 2

CONTENTS FEATURES

DEPARTMENTS

13 Hitting the mark: Defend against IRF audits and denials with coding and documentation improvements

3 Director’s note

Use these expert tips to tighten up IRF compliance and avoid costly denials.

21 A fresh perspective: Broaden the revenue integrity outlook with physician advisors Bring physician advisors’ unique mix of clinical and financial knowledge to your revenue integrity team.

25 Congratulations to our CHRI credential holders NAHRI would like to acknowledge our CHRI credential holders.

26 Solve the commercial payer audit puzzle

Welcome the new members of NAHRI’s Advisory Board and committees.

9 Note from the board Review the impact of the first months of CMS’ price transparency requirement and look ahead to the next steps.

CONTINUING EDUCATION CREDITS NAHRI members are entitled to one continuing education credit for reading the NAHRI Journal and taking the 20-question quiz.

Score a win on commercial payer audits with these tips.

31 Take control of Medicare Advantage denial challenges Learn how to cut through the confusion and use a team approach to solve these difficult denials.

NETWORK WITH THE NAHRI COMMUNITY

38 Meet a Member: A data analyst shares her experiences in denials prevention

Meet the NAHRI community on social media. Follow us on Facebook and Twitter. Share your favorite NAHRI Journal story with us by using the tag #NAHRIJournal. Next, introduce yourself on our LinkedIn group.

Get to know Tracey Tomak, RHIA, PMP.

NAHRI Journal (ISSN 2574-2051) is published quarterly by HCPro, 35 Village Road, Suite 200, Middleton, MA 01949. Subscription rate: $155/year for membership to the National Association of Healthcare Revenue Integrity. • Copyright © 2019 HCPro, a Simplify Compliance brand. All rights reserved. Printed in the USA. Except where specifically encouraged, no part of this publication may be reproduced, in any form or by any means, without prior written consent of HCPro or the Copyright Clearance Center at 978-750-8400. Please notify us immediately if you have received an unauthorized copy. • For editorial comments or questions, call 781-639-1872 or fax 781-639-7857. For renewal or subscription information, call customer service at 800-650-6787, fax 800-639-8511, or email customerservice@hcpro.com. • Visit our website at www.nahri. org. • Occasionally, we make our subscriber list available to selected companies/vendors. If you do not wish to be included on this mailing list, please write to the marketing department at the address above. • Opinions expressed are not necessarily those of NAHRI Journal. Mention of products and services does not constitute endorsement. Advice given is general, and readers should consult professional counsel for specific legal, ethical, or clinical questions.

2

NAHRI Journal | APRIL 2019

nahri.org

Profile for ACDIS

NAHRI Journal April 2019  

NAHRI Journal April 2019  

Recommendations could not be loaded

Recommendations could not be loaded

Recommendations could not be loaded

Recommendations could not be loaded