Emerging U.S. Regulatory and Payer Trends in Laboratory Revenue Cycle Management image

Emerging U.S. Regulatory and Payer Trends in Laboratory Revenue Cycle Management

U.S. clinical labs face mounting regulatory challenges and shifting payer dynamics that are fundamentally changing how laboratory revenue cycle management (RCM) must be handled. Staying ahead means mastering compliance, optimizing payor contracting, and modernizing medical billing for laboratories to protect revenue and reduce expensive denials. If you manage a clinical lab, you’ve likely experienced how yesterday’s billing strategies no longer deliver. To survive – and thrive – you need to rethink your approach.

Regulatory Trends Shaping Laboratory Revenue Cycle Management

The regulatory spotlight on clinical laboratories in the U.S. is intensifying. The Centers for Medicare & Medicaid Services (CMS), the Food and Drug Administration (FDA), and new federal mandates have made lab RCM

The Vital Role of Risk Adjustment Medical Coders Image

The Vital Role of Risk Adjustment Medical Coders

In today’s value-based healthcare environment, risk adjustment medical coders are essential to the financial health, regulatory compliance, and care quality of U.S. healthcare organizations. As CMS continues to evolve its HCC risk adjustment models and intensify audit scrutiny, the expertise of these professionals plays a pivotal role in ensuring accurate reimbursements and minimizing risk. 

This blog explores the evolving responsibilities of risk adjustment medical coders, the impact of their work on HCC risk adjustment coding, and best practices for healthcare providers looking to

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