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How to Modernize Your Healthcare Revenue Cycle: 3Gen Consulting’s Guide to Better Results

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 Outdated workflows and manual processes quietly erode revenue, create compliance risk, and add stress to your team.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.

Leverage Data-Driven Insights to Prevent Revenue Loss

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:

  • Analyzing claims, accounts receivable, and denial trends
  • Identifying gaps in medical coding and clinical documentation workflows
  • Highlighting high-risk areas like underreported services or incorrect modifiers

For more on leveraging data to prevent costly guesswork, see our blog: Data-Driven Healthcare Revenue Cycle Management: Why Guesswork Costs You Money.

Proactive Coding Audits: Stop Denials Before They Happen

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:

  • Focuses audits on high-risk areas
  • Identifies underreported services and documentation gaps
  • Implements automated tools to streamline analysis and reduce manual errors

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.

Streamline Revenue Cycle Processes with Automation

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:

  • Accelerate claim submissions and payment posting
  • Validate medical coding and documentation in real time
  • Reduce medical billing denials and rework
  • Track trends and generate actionable insights

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.

Invest in Staff Training and Development

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:

  • Evolving medical coding in USA guidelines and payer rules
  • Clinical documentation best practices
  • Workflow optimization and automation tools

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.

Why Partner with 3Gen Consulting

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:

  • Maximize reimbursements with accurate medical coding services and medical billing services
  • Reduce denials in medical billing and rework across accounts receivable
  • Implement AI automation and workflow optimization for efficiency
  • Ensure compliance with CMS, payer rules, and industry standards

Our integrated approach combines medical billing and coding services, AI-driven platforms, and strategic insights to strengthen financial performance and operational excellence.

Modernize Today to Safeguard Revenue Tomorrow

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.

The ABCs of Laboratory Billing- How Pathology Groups Can Stop Losing Revenue
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The ABCs of Laboratory Billing: How Pathology Groups Can Stop Losing Revenue

Running a pathology group or diagnostic laboratory is challenging enough – but revenue cycle challenges make it even harder. If your lab claims are being denied due to missing prior authorizations, incorrect CPT codes, or “medical necessity not met” errors, you’re not alone. 

Laboratory billing is one of the most complex areas of U.S. healthcare revenue cycle management (RCM). With payers tightening scrutiny on molecular and genetic testing, expanding prior authorization requirements, and rolling

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Deloitte Survey Indicates Now Is a Great Time to Outsource Medical Coding Image
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Deloitte Survey Indicates Now Is a Great Time to Outsource Medical Coding

As the challenges in the U.S. healthcare landscape continue to become more complex, healthcare revenue cycle leaders across hospitals, health systems, and physician groups will benefit from looking at new ways to outsource medical coding. From the long-term impacts of new federal legislation, to workforce shortages and the rise of AI-enabled payers, U.S. healthcare providers can no longer look at medical coding outsourcing as an option – it’s a strategic necessity. 

Instead, it should be leveraged as an opportunity to tap into skills, resources, and services that aren’t available internally. This perspective will be critical as competition for specialized skills increases and the tech arms race progresses. Outsourcing medical coding services should be a foundational pillar for building the kind of multidimensional sourcing ecosystem that this survey from Deloitte addresses [1].

To help you and your team better understand the role that medical coding outsourcing can play at your organization, we’ve put together the highlights from the survey for your review.  By prioritizing the benefits and strategies addressed below, you can transform your medical coding operations from a cost center into a strategic asset. 

Maturing Your Approach to Medical Coding Outsourcing

For U.S. hospitals, health systems, and physician groups, outsourced medical coding services are becoming a cornerstone of revenue cycle strategy. Delivery models are becoming more sophisticated and beginning to emphasize relationships based on value over simple cost savings. 

While some respondents to the survey reported beefing up internal operations, investments in external partnerships were also featured heavily, with only a few respondents planning a decrease. Back-office functions continue to be outsourced at higher rates, but organizations are increasingly focused on creating greater value from core competencies. For revenue cycle leaders considering medical coding outsourcing, this trend is worth paying attention to. It highlights the fact that a strategic approach to medical coding outsourcing can be a decisive factor in achieving operational agility and securing skilled talent, and more than just a cost cutting measure.

The Deloitte survey highlights this shift away from a focus on cost savings in outsourcing.  This evolving perspective redefines the value proposition of outsourced services – moving the focus from sourcing inexpensive labor to acquiring high-value capabilities, like specialization in the healthcare revenue cycle. 

Revenue cycle leaders should now prioritize improved access to talent, enhanced service quality, and greater agility, in addition to spend optimization. While cost reduction will remain a consideration in medical coding outsourcing, the strategic priority must be on discovering continuous opportunities for creating incremental value. This means working with your revenue cycle vendor to access talent, integrate advanced technology, and enhance core capabilities.

Access the Distinct Value of Back-Office Outsourcing

The survey reveals that back-office outsourcing remains a foundational component for many organizations. These functions are being outsourced at elevated rates, allowing businesses to concentrate on their primary competencies while benefiting from a provider’s specialized knowledge to continue driving operational efficiency. By focusing on back-office outsourcing, U.S. healthcare revenue cycle departments can access benefits including:

  • Enhanced access to medical coding talent
  • Improved quality and performance
  • Ability to gain access to new capabilities

Medical coding services, a critical back-office function, are prime candidates for this model. Revenue cycle departments should adopt a comprehensive sourcing strategy and integrate outsourced medical coding services as an integral component of their overall operating model. This approach moves beyond a piecemeal solution, positioning the department to capture the full benefits of a strategic partnership.

Prioritizing Value-Based Relationships and Addressing Challenges in Your Revenue Cycle Outsourcing Strategy

To maximize the impact of your investment in a medical coding outsourcing partner, focus on vendors who are experienced in healthcare and who can provide a relationship based on value. 

Deloitte recommends collaborating with your service provider to explore new areas of creating this value. 

Keep in mind, many organizations encounter challenges in their outsourcing programs, many of which stem from internal management capabilities. The survey points out key internal obstacles to success, including: 

  • An inadequate approach to organizational change management
  • Poor integration of vendor services
  • An inability to track and report on realized benefits
  • Insufficient financial oversight

To get ahead of these challenges, revenue cycle leaders need to bolster their internal management capabilities and apply them directly to outsourced services. This includes areas of competency including: 

  • Value management
  • Performance oversight
  • Effective vendor relations

To maximize value from an outsourcing program, your leadership should reach out to embrace strategic measures in their outsourcing program. This includes defining a comprehensive sourcing strategy and integrating outsourcing as a fundamental part of your global operating model. In the world of outsourcing medical coding, this translates into a need for a well-defined strategy that considers the impact on the entire revenue cycle function.

Future-Readiness Hinges on Talent Sourcing

To prepare for the future, revenue cycle departments must leverage external partnerships to manage complexity and deliver results. The possibilities of the modern talent pool are expanding, and organizations are adjusting their sourcing approach to gain flexibility, efficiency, and access to specialized skills.

No executive from the Deloitte survey reported relying exclusively on internal employees for their talent requirements. For a provider considering a medical coding outsourcing partner, this means looking for a vendor with a sophisticated approach to talent management, beyond simple staff augmentation. Providers should look for opportunities to collaborate across internal departments, developing new competencies, and potentially recruiting personnel with a broad experience of managing diverse talent models. A well-executed medical coding outsourcing program can be a key part of this overall talent strategy.

Supercharge Your Medical Coding Outsourcing Strategy With AI

The Deloitte survey highlights the importance of a fresh strategic perspective on your outsourcing practices. This type of strategic partnership can help your organization access a deeper pool of skilled medical coders, enabling improved accuracy and reduced claim denials.

These benefits are greatly enhanced when working with a partner that leverages AI solutions on top of their deep experience in healthcare. At 3Gen Consulting, our AI coding platform, CodeGen-i, combines the speed and efficiency of AI-assisted coding with the assurance of certified coder review. Every chart is validated by an experienced coding professional, so clients gain both productivity and a higher level of accuracy. To learn more about how we can partner as a part of your future-ready outsourcing strategy, contact us today.

 

References

[1] Deloitte, “Global Outsourcing Survey 2024,” 5 February 2025. Available: https://www.deloitte.com/content/dam/assets-zone3/us/en/docs/services/consulting/2024/us-global-outsourcing-survey-2024-report.pdf.

7 Best Practices for Medical Billing & Coding Services That Boost Revenue and Reduce Denials Image
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7 Best Practices for Medical Billing & Coding Services in 2025 to Boost Revenue and Reduce Denials

If you’re a U.S. healthcare provider searching for medical billing and coding services, you’re not alone. Thousands of physician practices, hospitals, and labs nationwide are rethinking how they manage revenue cycle operations – because missed modifiers, lost claims, and endless denials are draining revenue.

Medical billing and coding errors cost U.S. providers billions annually — not just in unpaid claims, but also in compliance risk, staff burnout, and unhappy patients. The good news? With the right blend of technology, process, and expertise, most of these issues are preventable.

Here are 7 proven best practices that top-performing practices, physician groups, and hospitals use to keep cash flow healthy, denials low, and compliance airtight.

1. Keep Your Medical Coding Guidelines Updated — Always

Billing and coding are constantly evolving. Every year, CMS, AMA, and commercial payers release updates to CPT, ICD-10, and HCPCS codes. Missing even one update can lead to underpayment or denials — especially in specialties with frequent coding changes like radiology, pathology, and behavioral health.

Best Practice:

  • Maintain a living medical coding manual updated quarterly.
  • Subscribe to payer alerts and CMS updates.
  • Use AI-powered medical coding tools to flag outdated codes before claims go out.

Pro Tip: U.S. practices that review coding guidelines regularly see 15-20% fewer denials related to coding errors.

2. Verify Patient Eligibility Upfront

One of the most common reasons for denials? Ineligible patients. Nothing is more frustrating than delivering care and discovering after the fact that coverage lapsed or prior authorization was required.

Best Practice:

  • Run real-time eligibility checks for every patient.
  • Verify coverage for high-cost procedures and check prior authorization requirements.
  • Document payer reps’ names and reference numbers when you confirm coverage.

Industry Insight: According to MGMA, eligibility issues account for nearly 27% of claim denials [1]. Catching them upfront saves you rework and write-offs.

3. Get Documentation Right the First Time

Clean documentation is the backbone of clean claims. If the diagnosis doesn’t support the CPT, or if signatures and dates are missing, your claim will end up in a denial queue.

Best Practice:

  • Use a documentation checklist that includes DOS, provider signature, and diagnosis-procedure match.
  • Standardize templates in your EHR for consistency.
  • Perform spot-checks on high-value procedures before submission.

Even a single missed modifier (like 25, 59, or 26/TC) can mean a $500+ revenue loss. Getting it right upfront pays off – literally.

4. Track Key Medical Billing KPIs Like a Hawk

You can’t improve what you don’t measure. Practices that monitor their revenue cycle KPIs consistently outperform those that don’t – and can intervene early when something goes wrong.

Best Practice: Track at least these core metrics:

  • Clean Claim Rate (Target: 95%+)
  • First Pass Resolution Rate
  • Days in AR (Target: < 35 days for most specialties)
  • Denial Rate by Category

Use a medical billing dashboard to visualize trends and take action before denials snowball into revenue leakage.

5. Perform Regular Coding Audits

Medical coding audits aren’t just for compliance – they’re for revenue protection. Undercoding costs you money, while overcoding can trigger audits and penalties.

Best Practice:

  • Conduct quarterly internal audits (retrospective + pre-bill).
  • Train your staff on findings so errors don’t repeat.
  • Use audits to identify missed units, unbilled add-on codes, and downcoded encounters.

Our experience shows that proactive audits can recover 3-7% of missed revenue without increasing patient volume.

6. Automate Medical Billing & Coding Workflows

Manual data entry, claim status chasing, and payment posting are productivity killers. The best U.S. practices are investing in automation and AI-driven RCM platforms to streamline processes.

Best Practice:

  • Leverage AI-assisted coding tools to reduce errors.
  • Automate claim status checks, payment posting, and denial routing.
  • Integrate your EHR, clearinghouse, and billing platform to eliminate duplicate data entry.

Providers using automation report 20–30% faster reimbursement cycles and lower staff workload.

7. Train & Upskill Your Team Continuously

The medical billing and coding landscape changes fast – and a one-time training isn’t enough.

Best Practice:

  • Host quarterly lunch-and-learns on payer changes.
  • Encourage coders to maintain AAPC or AHIMA certifications.
  • Provide feedback loops: share audit findings and celebrate improvements.

The Bottom Line: Best Practices Pay for Themselves

Implementing these best practices doesn’t just clean up your healthcare revenue cycle, it also improves compliance, reduces staff burnout, and keeps patients happier. 

But keeping up with payer changes, coding updates, and endless claim follow-ups can overwhelm even the best in-house teams.

That’s where RevGen-i, 3Gen’s AI-powered revenue cycle management platform, comes in. With RevGen-i, U.S. healthcare providers get:

  • Real-time eligibility verification to stop denials before they start
  • Intelligent analytics dashboards to track clean claim rates, denial categories, AR days
  • Workflow automation for claim status checks, payment posting, and follow-ups
  • Seamless integration with EHR and billing systems for a frictionless workflow

Together with our expert billing team, RevGen-i helps U.S. providers stay compliant, capture every dollar, and get paid faster, without adding staff or complexity.

Ready to see the difference? Schedule your free RCM assessment and see how much revenue you might be leaving on the table.

References

[1] MGMA, “6 keys to addressing denials in your medical practice’s revenue cycle,” 18 March 2021. Available: https://www.mgma.com/mgma-stats/6-keys-to-addressing-denials-in-your-medical-practice-s-revenue-cycle.

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