Oversight in the lab industry has just taken a major blow from the FDA – and every laboratory needs to rethink its revenue cycle strategy.
Earlier this year, the FDA rescinded its 2024 rule that would have treated
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 Outdated workflows and manual processes quietly erode revenue, create compliance risk, and add stress to your team.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
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
AI in Healthcare Revenue Cycle: The Big Opportunity in Medical Billing Accounts Receivable
A recent HFMA study shows that hospital CFOs see revenue cycle – especially medical billing accounts receivable and denials management – as the biggest area of opportunity for AI [1]. This raises a key question: what do revenue cycle leaders need to do to prepare? Considering the complexity of AI technology, choosing a good partner with “pre-AI” revenue cycle expertise is
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.
