From The Desk of CEO

After releasing new HCC coding guidelines, CMS has published the latest Medicare Advantage Rate announcements, sparking speculation around the impact on providers. These potential impacts include shifts in Medicare Advantage enrollment, questions around the effects of changing economic conditions, and ...

In the high-stakes world of healthcare finance, where razor-thin margins and rising regulatory scrutiny are the norm, medical coding audits have become essential for maintaining revenue integrity, ensuring medical coding compliance, and supporting long-term sustainability. While many providers focus on ...

Switching out legacy IT systems can be a time of change and disruption for healthcare revenue cycle leaders – but it can also be a time of opportunity. While many leaders will look for ways to identify high-performing replacement solutions ...

The healthcare revenue cycle has seen major trend upheaval lately, many of which have significant impact on how revenue cycle leaders should approach decisions around medical billing services in the USA.  Becker’s Healthcare has highlighted eight key trends, and one ...

Outdated healthcare accounts receivable management costs more than many healthcare leaders realize. Many are hobbling along, making small tweaks to systems and processes that don’t come close to the goal of true modernization – and they’re paying for it. Payment ...

For years, vendor partners were icing on the cake for many healthcare providers – medical coding outsourcing services were something leadership considered under specific circumstances or in response to certain external pressures in the industry. This, though, has changed. Innovation ...

Healthcare providers are dropping major insurers – and home health ...

Medical coding should look to supply chain leadership for guidance in navigating increasing cost pressures in healthcare.  Black Book recently released a poll of over 1,000 operations ...

Social determinants of health (SDoH) are directly impacting medical coding, and more providers should pay attention. Health.gov defines SDoH as “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide ...

Healthcare providers across America burned almost $20 billion dollars in 2022 on medical billing accounts receivable – and it all went to chasing down denials and delays with payers . The numbers look even more disheartening with a focus on ...

At 3Gen, we’ve talked for a while about the growing importance of risk adjustment coding—and our rationale is being proven true.  Part of the OIG’s responsibility is conducting health plan audits of Medicare Advantage organizations to identify fraud and reduce ...

Outsourcing revenue cycle management services is turning out to be a smart option for an increasing number of providers. In 2023, 61% indicated they are considering outsourcing tasks to revenue cycle management companies in the next 24 months .  But ...

Adolescent confidentiality has come up more in the news lately, largely because of advances like the HPV vaccine, which can be administered as young as 11 or 12 years old. Because of this, many providers, obstetrician-gynecologists especially, should take time ...

Patients’ experience in hospitals and hospital billing can vary significantly, even if two hospitals are just a few miles away from each other. In essence, the American patient has no idea what their financial experience will be when they step ...

Medical providers should be doing everything they can to get in front of the medical billing changes that are coming next year – and this starts with understanding what’s in the forecast ...

Revenue cycle management has grown to an unmatched level of complexity in recent years. For most organizations, this has meant increased needs for training and improved hiring processes – but is it possible there’s a limit to the effectiveness of ...

With Q4 of 2023 coming around the corner, it’s time to start looking at plans for 2024. It might not seem like it should make your short list of priorities, but medical coding audits should be on the mind of ...

Think back to what your AR processes looked like before the COVID-19 pandemic – how much do they have in common with the way your medical billing accounts receivable processes look today? If they’re too similar, I’m sorry to say ...

Healthcare providers across the board should be ready to expect more medical coding audits.  What’s coming down the pipeline shouldn’t catch anyone by surprise. ...

If you’ve been paying attention to what’s going on with healthcare in Florida, you probably know that the Florida House passed a bill that gives physicians the option to opt out of services for reasons of conscience – meaning they ...

Healthcare provider finance is moving into an entirely new era. As margins continue to be strained, CFOs are facing new challenges such as the end of the public health emergency, staffing shortages, and millions potentially being thrown off the Medicaid ...

One of my greatest concerns around AI isn’t that it’s going to one day go rogue and cause massive issues for some unfortunate provider. I believe the chances of that are slim to none. My deepest concern is potential missed ...

As of May 11, 2023, the COVID-19 public health emergency (the PHE) is ending in the United States. While many are breathing a sigh of relief, revenue cycle ...

If you’ve looked at trends of the future of work, you might have noticed something interesting. You’ll see points like hybrid flexibility, addressing employee mental health, closing ...

The concept of hospital at home – providing hospital-level care inside the patient’s home – is far from ...

The No Surprises Act has made a stir across the healthcare industry, but it ...

“Quiet quitting” has been leading the workplace trend discussion for a while now, which ...

There are many great recommendations for key KPIs to focus on in evaluating your approach ...

From telehealth to public health data reporting, patient-centered initiatives are at the heart of almost all the disruption we’re ...

Collaboration has long been important to revenue integrity, but we’re entering an ...

Most hospitals and health systems are years deep into their patient engagement and patient experience strategies. Many have also seen great results – from initiatives ...

While patient volumes aren’t the rollercoaster they were early in the pandemic, for many, they’re still difficult to pin down. But that’s just the beginning. ...

Providers have been faced with an onslaught of fires and blaring alarms over the last few years, making it easy for revenue cycle leaders to run from emergency ...