Accuracy gets all the attention in risk adjustment coding, and rightly so. It’s the backbone of compliance, reimbursement, and audit defense.
But here’s the truth: accuracy alone doesn’t keep your revenue cycle moving – productivity does.
That’s where many healthcare organizations and risk adjustment coding
The home health revenue cycle has experienced ongoing changes in recent years, and this year is no different. The Centers for Medicare & Medicaid Services (CMS) has announced more changes to nursing home staffing requirements, opening up opportunities for leadership to make strategic adjustments. These adjustments create downstream impacts on home health billing and home health
The 2025 Clinical Laboratory Fee Schedule (CLFS) update has given U.S. labs extra time to prepare for the upcoming January 1 – March 31, 2026, reporting period. Originally announced in 2024, this update delayed certain data
Healthcare organizations face constant pressure: rising medical billing denials, delayed reimbursements, evolving regulations, and overstretched staff. Outdated workflows and manual processes quietly erode revenue, create compliance risk, and add stress to your team.
For provider groups across the USA, every delayed claim or denied payment isn’t just lost revenue – it’s added operational pressure. At 3Gen Consulting, we understand these challenges. Modernizing your medical billing services, medical coding, and revenue cycle management (RCM) isn’t just a buzzword – it’s a pathway to measurable improvements in efficiency, compliance, and financial performance.
Here’s how healthcare organizations can transform their revenue cycle for better results.
Decisions based on assumptions or “we’ve always done it this way” thinking can quietly erode revenue. 3Gen Consulting, a leading medical billing company, helps organizations leverage analytics in revenue cycle management to spot inefficiencies, reduce denials, and improve medical billing accounts receivable.
Our data-driven approach includes:
For more on leveraging data to prevent costly guesswork, see our blog: Data-Driven Healthcare Revenue Cycle Management: Why Guesswork Costs You Money.
Coding errors are one of the leading causes of denials in medical billing, delayed payments, and compliance headaches. Missing documentation, incorrect modifiers, and underreported services can quietly drain revenue and trigger audits.
3Gen’s coding audits help organizations catch these issues early. Our approach:
By addressing vulnerabilities before claims submission, your medical billing and coding company can minimize rework, maintain compliance, and protect revenue.
Dive deeper into auditing best practices here: Medical Coding Audits 101: How Physicians Can Stay Ahead of the Curve.
Manual workflows increase the risk of errors and slow down revenue cycle management services. AI-powered automation can transform your RCM processes. 3Gen’s suite of platforms – including RevGen-i, CodeGen-i and RiskGen-i – streamlines claims processing, coding and risk adjustment with precision.
By integrating automation, your team can:
Modern RCM isn’t just faster – it’s smarter, freeing staff to focus on strategic initiatives rather than repetitive tasks.
Explore our CEO’s insights on AI in RCM: AI in Healthcare Revenue Cycle: The Big Opportunity in Medical Billing Accounts Receivable.
Even the most advanced AI tools and audit programs are only as effective as the people using them.
Continuous staff education ensures your team stays current on:
3Gen’s provider education programs upskill coders and billers to think like auditors, enabling them to prevent errors before claims are submitted. This targeted education improves compliance, reduces medical billing denials, optimizes overall medical billing and coding efficiency, and equips teams for future AI integration and evolving payer requirements.
Learn more about the impact of targeted education here: Medical Coding Audits: The Silent Guardian Against $36 Billion in Annual Compliance Risks.
Modernizing your revenue cycle management is complex, especially with limited resources and evolving regulations. As a trusted medical billing company, 3Gen Consulting helps provider groups:
Our integrated approach combines medical billing and coding services, AI-driven platforms, and strategic insights to strengthen financial performance and operational excellence.
Revenue cycle management is dynamic. Outdated workflows cost money, slow down staff, and increase compliance risks. By adopting data-driven insights, proactive coding audits, AI automation, and staff education, healthcare organizations can anticipate issues before they arise, reduce medical billing denials, streamline accounts receivable, and protect revenue.
With a trusted partner like 3Gen Consulting, healthcare organizations can turn challenges into opportunities, modernizing their revenue cycle to achieve long-term financial stability and operational excellence.
Effective October 1, 2025, the American Medical Association (AMA) introduced 25 new Proprietary Laboratory Analyses (PLA) codes, along with two deletions and one revision [1]. For U.S. labs and billing teams, these changes are more than just paperwork – they directly impact claims, revenue, and compliance.
With the right approach and tools like RevGen-i, labs can implement these updates efficiently, minimize errors, and safeguard revenue.
PLA codes represent specialized clinical lab tests that may be offered by a single laboratory or licensed to multiple providers. These codes cover advanced diagnostics such as oncology panels, transplant monitoring, and rare disease sequencing.
Accurate coding is crucial for U.S. labs and billing teams. Proper PLA code usage ensures claims are processed correctly, reduces denials, and helps capture full reimbursement for proprietary lab analyses.
The October 2025 AMA updates introduce several significant changes:
Deleted Codes: 0450U and 0451U, both related to multiple myeloma testing using LC-MS/MS.
Revised Code: 0333U now applies only to the HelioLiver™ Test by Helio Genomics® for liver oncology surveillance.
New Codes: 25 new PLA codes span oncology, transplant, neuro, infectious disease, and gastrointestinal diagnostics. Key additions include:
Labs should review the full list and ensure their U.S. lab billing services are updated to reflect these changes, verifying each code against internal testing menus and payer requirements.
PLA code updates are more than just administrative housekeeping – they directly impact revenue, compliance, and operational efficiency. Acting quickly ensures your lab billing services team stays ahead of potential issues.
Revenue Accuracy is critical. Submitting a claim with the wrong PLA code can lead to denials, delayed payments, or under-reimbursement.
Regulatory Compliance is another key factor. PLA codes are proprietary, and incorrect coding can trigger audits or compliance flags.
Workflow Efficiency matters too. Updating codes manually can be time-consuming and error-prone, slowing down your entire claims process.
Implementing PLA code updates doesn’t have to slow your lab down. RevGen-i, 3Gen Consulting’s AI-driven billing platform, acts as a smart co-pilot for U.S. lab billing services.
With RevGen-i, labs can:
By integrating RevGen-i, labs can reduce manual errors, improve efficiency, and protect revenue – all while staying compliant with AMA coding requirements.
The October 2025 PLA code updates are live, and labs that act proactively will benefit from smoother workflows, accurate claims, and optimized revenue. Leveraging smart tools like RevGen-i ensures that PLA code changes are implemented seamlessly, letting billing teams focus on efficiency rather than errors.
For labs looking to strengthen their lab billing services, accuracy alone isn’t enough. Proactive workflow management and AI-enabled automation are key to staying ahead in today’s evolving coding landscape.
Contact us to learn how RevGen-i can simplify PLA code updates for your lab.
[1] AMA, “CPT® Proprietary Laboratory Analyses (PLA) Codes: Long Descriptors,” 1 October 2025. Available: https://www.ama-assn.org/system/files/cpt-pla-codes-long.pdf.
