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NHIA Reimbursement Training Center

NHIA’s Payer Advocacy and Relations Committee (PARC) has developed this reference to assist NHIA members in orienting their staff to common practices throughout the reimbursement cycle.  This reference is now available as a NHIA member-only benefit.

Every organization must assume responsibility for all compliance aspects of their billing, coding and other claiming practices, HIPAA and otherwise. While we are comfortable with the quality of this document, NHIA assumes no liability that use of these procedures conforms to Payer regulations or other norms of business practice that have been established within your organization. Use of this document is meant to support training, and should not be considered a replacement for training practices within your organization.

Introduction

The goal of the reimbursement function is to transform the services provided into cash for your organization. This is often referred to as the revenue cycle. The revenue cycle consists of a series of steps, often performed by different personnel, or even departments, depending on the size of the organization. This site breaks down those steps as follows:

  • Intake: Insurance Verification and Authorization
  • Billing and Coding
  • Collections
  • Cash Posting

 

The guide also includes information regarding the variety of therapies provided by home and specialty infusion providers, payer types, reimbursement methodologies, and infusion suites.

Please contact marianne.buehler@nhia.org if you have any questions or comments about the NHIA Reimbursement Training Center.

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