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The RCxRules Blog
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HCC Coding
Revenue Cycle
Revenue Cycle
January 31, 2024
New Year, New Preventive Medicine Benefits
The new year is the perfect time to encourage patients to take advantage of preventive medicine covered by their insurance. For Medicare patients, …
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HCC Coding
January 31, 2024
Important Changes to MIPS Reporting in 2024
With each reporting year, CMS makes changes to MIPS reporting requirements. Some are regulatory changes that are required based on timelines set in …
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Revenue Cycle
December 22, 2023
New Medicare E/M Complexity Add-On Code G2211
What is CPT Code G2211? Beginning January 1, 2024, Medicare is implementing CPT code G2211 which is an add-on code that represents the additional …
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HCC Coding
December 21, 2023
RCxRules HCC Coding Engine Updates for the V28 Transition
CMS implemented significant changes to the HCC model in V28 being rolled out in 2024. Why are these changes important? Because they will …
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Revenue Cycle
November 28, 2023
The Importance of ABNs for Healthcare Providers
As healthcare providers, it is crucial to make sure your patients understand their rights and responsibilities when it comes to their care. It is …
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HCC Coding
November 28, 2023
MIPS 2023 Reporting: Promoting Interoperability and Improvement Categories
Last month’s blog discussed MIPS reporting under the Quality Payment Program (QPP). Let’s take a deeper look at the MIPS Promoting Interoperability …
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HCC Coding
October 30, 2023
Understanding the Quality Reporting Component of Value-Based Care
In today's rapidly evolving transition to value-based care, healthcare providers face the challenge of delivering high-quality care while …
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Revenue Cycle
October 30, 2023
The Role of Medical Necessity in Healthcare
When it comes to healthcare services, medical necessity guidelines are important for insurance coverage and correct coding rules. Medical necessity …
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HCC Coding
September 29, 2023
How RCxRules Can Help You Navigate the Change from V24 to V28
HCC model V28 was recently approved by CMS and will begin to take effect in 2024. The new model will require even greater specificity in …
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Revenue Cycle
September 26, 2023
The Compounding Benefits of a Proactive Approach to Denial Management
Staying on top of denial management can feel like a never-ending spiral. Addressing billing and coding errors only after they’ve resulted in a denial …
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HCC Coding
September 1, 2023
An Expert’s Take on HCC Coding
Meet our Guest Writer: Kate Casaday
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Revenue Cycle
August 28, 2023
Real Results from RCxRules Users
At RCxRules, we know we’re only as successful as our customers. We can back up our products with statistics and data, but at the end of the day what …
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HCC Coding
July 20, 2023
Unbelievable Stats and Other Insights from the Risk Adjustment Innovations Conference
Representatives from The Office of Inspector General (OIG) presented at this year’s Risk Adjustment Innovations Conference and provided some …
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Revenue Cycle
June 8, 2023
Revenue Cycle Company Brings Medical Practices Live 66% Faster While Continuing to Grow Their Revenue
Koha Health supports independent orthopedic and aligned musculoskeletal practices and ASCs in achieving total financial health by addressing both the …
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Revenue Cycle
May 19, 2023
How HNI Healthcare Reduced Denials and Achieved a 40% Automation Rate
HNI Healthcare is a healthcare technology and physician practice management company focused on improving clinical, operational, and financial …
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HCC Coding
May 4, 2023
HCC Model v28 Proposed Changes: Opposing Viewpoints
CMS has proposed a new risk adjustment model version (v28) for 2024 that is based on more recent data. These proposed changes would use a new ICD-10 …
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Revenue Cycle
April 28, 2023
How Eleanor Health Reduced Their Month-End Closing Time from 15 Days to Just One
Eleanor Health is a provider of mental health treatment and substance use and associated behavioral disorder treatment based in Massachusetts that …
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Revenue Cycle
April 7, 2023
Use Cases for AI in Healthcare
What is Artificial Intelligence (AI) in Healthcare?
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HCC Coding
March 24, 2023
How to Track and Measure Provider Support Activities in Real Time
Providers went to medical school to become doctors, not coders. They excel at providing patient care, but often struggle to translate the care …
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HCC Coding
February 28, 2023
How to Succeed in Value-Based Care Without In-House HCC Coders
HCC coders are a crucial part of identifying revenue opportunities in value-based care. So what to do if your organization isn’t ready for an …
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Revenue Cycle
February 16, 2023
RCxRules Conferences and Events: Where Should We Go?
Conferences and events are a great opportunity for the RCxRules team to meet with prospective new customers and connect with existing partners and …
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Revenue Cycle
January 19, 2023
How ENT and Allergy Associates Automatically Corrects 82% of Their Claim Errors
ENT and Allergy Associates has more than 300 clinicians practicing in over 55 office locations in New York and New Jersey. The practice sees over …
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Revenue Cycle
December 15, 2022
How RCxRules Crowdsources Content to Help You Stay One Step Ahead
The RCxRules Revenue Cycle Engine is a custom solution tailored to address the unique needs of a medical group. While implementing the solution, the …
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HCC Coding
December 8, 2022
AAPC Case Study: Converting Risk into Revenue
Between June and December 2021, AAPC Services performed risk adjustment audits using the V24 Medicare Advantage model and dates of service from large …
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HCC Coding
November 15, 2022
How to Get Leadership Buy-in for HCC Coding Solutions
Succeeding in value-based care isn’t easy. Current staffing shortages and remote work challenges make succeeding even more difficult. Many groups are …
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Revenue Cycle
October 26, 2022
Partners in Success: What to Expect from the RCxRules Implementation Process
The Revenue Cycle Engine works to simplify the complex revenue cycle process by turning an organization’s unique knowledge and expertise into highly …
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HCC Coding
October 18, 2022
How Center for Primary Care Improved their HCC Coding Without Hiring Additional Staff
Center for Primary Care (CPC) is headquartered in Georgia and has over 40 providers in eight locations across two states. They have been providing …
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HCC Coding
September 22, 2022
Why You Need an Experienced HCC Coach to Succeed in Value-Based Care
Value-based care is incredibly complex and navigating the challenges of HCC coding in addition to care coordination, chronic care management, and …
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Revenue Cycle
September 20, 2022
Insights from the RCxRules 2022 National User Conference: Staffing Shortages and Remote Work are Still Top of Mind
RCxRules hosted our 2022 National User Conference in August—our first in-person conference since 2019! Attendees traveled from across the country to …
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HCC Coding
August 30, 2022
2023 Is Coming! Plan (and Budget) for These Risk Adjustment Challenges
Medical groups today are facing unprecedented levels of provider burnout and staffing shortages. To succeed in value-based contracts, groups need to …
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Revenue Cycle
August 16, 2022
6 Overwhelming Statistics that Illustrate the Staffing Challenge RCM Leaders are Up Against
Hiring and retaining revenue cycle management staff has always been a challenge—and it’s more difficult now than ever. These statistics offer a …
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HCC Coding
July 28, 2022
A Risk-Free Approach to Risk Adjustment: A New Managed Service from RCxRules and AAPC
RCxRules and AAPC are partnering to offer a new managed service that improves RAF score accuracy while helping medical groups overcome today’s …
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Revenue Cycle
July 21, 2022
How U.S. Dermatology Partners Achieved Their Highest Clean Claim Rates Despite Staffing Challenges
U.S. Dermatology is headquartered in Dallas, Texas, and has more than 94 locations across Arizona, Colorado, Kansas, Maryland, Missouri, Oklahoma, …
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HCC Coding
June 22, 2022
Key Takeaways from the 2022 APG Annual Conference: ACO REACH and Health Equity
James Nichols from RCxRules shares his key takeaways from the APG Annual Conference below.
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Revenue Cycle
June 9, 2022
New eBook: Simplify Your Revenue Cycle Workflow Through Automation
Provider burnout is an ever-increasing problem, and employees across the healthcare industry are overworked and overburdened. The prevalence of EMRs …
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Revenue Cycle
May 26, 2022
How to Improve Revenue Cycle Integrity as Denials Trend Upwards
What is Revenue Cycle Integrity? Revenue cycle integrity is a broad term that can mean different things across different industries. In the context …
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HCC Coding
May 10, 2022
3 Reasons Why It’s Time to Switch to a Concurrent Risk Adjustment Review
Medicare Advantage continues to grow, making HCC capture a priority for more medical groups than ever. Accurate RAF scores are critical to success, …
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HCC Coding
April 21, 2022
Managing HCC Capture During the Great Resignation
We’re all familiar with the staffing challenges facing the healthcare industry. A staggering 79% of health care professionals say the national worker …
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Revenue Cycle
April 14, 2022
How Pacific Cataract and Laser Institute Achieved Their Lowest-Ever Rejection Rates
Pacific Cataract and Laser Institute (PCLI) specializes in cataract surgery and laser vision correction. With 17 locations in 6 states and over 1,700 …
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HCC Coding
March 24, 2022
Key Takeaways from RISE National 2022
Karen Weed, VP of Value-Based Solutions at RCxRules, attended the RISE National 2022 annual conference and shares her takeaways in this blog post.
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Revenue Cycle
March 10, 2022
Overcoming Revenue Cycle Management Staffing Challenges
Hiring and retaining staff in the healthcare field is a challenge that isn’t going away anytime soon. The pandemic has taken a serious toll on …
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HCC Coding
February 16, 2022
Overcoming HCC Challenges in 2022: Provider Burnout, Staffing Challenges, and Coding Gaps
With 2022 underway, it’s clear the impact of value-based care on the bottom line of medical groups across the country is continuing to grow. …
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Revenue Cycle
February 10, 2022
An Update from our CEO: Another Strong Year for RCxRules and Our Clients
In 2021, COVID-19 continued to disrupt lives and pose health challenges for many Americans. We greatly appreciate the efforts of everyone throughout …
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HCC Coding
January 25, 2022
False Claims Act and MAOs: Important Takeaways for Provider Groups
The Medicare Advantage program continues to grow as more and more Medicare-eligible beneficiaries enroll. In 2020, the program provided health care …
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Revenue Cycle
January 13, 2022
Bad Data, Evolving Payer Requirements, and Staffing Challenges: Overcoming Roadblocks in 2022
As we all know, 2021 was a tough year in healthcare. While hopeful things will start to improve in 2022, provider burnout remains an ever-increasing …
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Revenue Cycle
December 28, 2021
How athenahealth Users Leverage the Revenue Cycle Engine for Increased Efficiency
Every large medical group faces unique challenges—challenges that cookie-cutter solutions can’t necessarily address. At RCxRules, we work with many …
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HCC Coding
December 21, 2021
Key Takeaways from the APG Annual Conference 2021
The America's Physician Groups (APG) annual conference was back in San Diego after a more than two-year break. Bobby von Bremen, Vice President of …
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Revenue Cycle
November 18, 2021
How Leading NextGen Users Leverage our Revenue Cycle Engine
Ensuring accuracy in coding and billing processes traditionally involves a significant amount of manual review work. At RCxRules, our focus is on …
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HCC Coding
November 9, 2021
HCC Coding Automation: NLP Technology vs HCC Coding Software
Using HCC coders alone is a costly approach to improving HCC capture and re-capture rates, which is why many organizations turn to technology to …
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Revenue Cycle
October 21, 2021
Keeping Pace: Complex Immunization Requirements
With fall arriving and winter just around the corner, many medical organizations are experiencing an increase in immunization-related appointments …
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HCC Coding
October 7, 2021
Overcoming Common HCC Coding Challenges Part 3: Making the Case to Leadership to Expand HCC Coding Efforts
The final installment in our blog post series on overcoming common HCC coding challenges tackles the issue of leadership buy-in. This …
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Revenue Cycle
September 21, 2021
Medical Coding Automation: A Coding Team's Secret Weapon
As Artificial Intelligence (AI), Robotic Process Automation (RPA), and medical coding automation grow, medical coders and billing staff may be …
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HCC Coding
September 9, 2021
Overcoming Common HCC Coding Challenges Part 2: Understanding Payer Feedback and Turning it Into Action
Next up in this series of posts featuring case studies that demonstrate how top-performing medical groups overcame common HCC coding challenges is an …
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Revenue Cycle
August 19, 2021
Keeping Pace: Surgical Specialty Requirements
On top of the usual billing and coding challenges faced by all providers, specialty practices across the country have additional requirements to …
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HCC Coding
August 5, 2021
Overcoming Common HCC Coding Challenges Part 1: Limited Coder Staffing
In our extensive experience working with population health teams, we’ve seen them grapple with several challenges when it comes to HCC coding. In …
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Revenue Cycle
July 15, 2021
A Revenue Cycle Guide for Private Equity Firms in Healthcare
Private equity firms have taken on a significant role in the healthcare industry over the last decade. In 2018, the valuation of private equity deals …
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HCC Coding
July 8, 2021
Tips for Querying a Physician to Improve HCC Coding Accuracy
What is a Physician Query? The American Health Information Management Association (AHIMA) defines a physician query as “a communication tool or …
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Revenue Cycle
June 22, 2021
The Key to Denial Management in Healthcare: Intervene on the Front End
Denial management in medical billing and coding can be complex, but there are ways to simplify the process. As many as 65% of claim denials are never …
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HCC Coding
June 10, 2021
How to Use HCC Analytics to Improve Provider Education and Point-of-Care HCC Capture
To improve point-of-care HCC coding capture among providers, most ACOs and population health teams rely on provider education programs. Successfully …
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Revenue Cycle
May 20, 2021
What Are Custom Claim Edits and Why Are They Important?
What are claim edits? According to Healthcare Innovation, healthcare claims editing is a step in the claims payment cycle that involves verifying …
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HCC Coding
May 6, 2021
Why ACOs Are Evolving from a Retrospective Coding Review to a Concurrent Coding Review
Moving from a retrospective coding review process to a concurrent coding review process has many advantages. Learn why some of the most progressive …
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Revenue Cycle
April 20, 2021
How to Achieve Clean Claims with Less Effort
What is a clean claim? According to AAPC, a clean claim is defined as “a claim free of any errors.” Submitting these the first time around is …
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HCC Coding
April 8, 2021
How Smart Rules Can Help Close the Gap Between Clinical Documentation and Coding
HCC coding is a significant challenge for providers—even those who are already accustomed to thorough clinical documentation. As we discussed in our …
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Revenue Cycle
March 25, 2021
Medical Coding Software: 3 Things to Look for When Choosing a Vendor
Medical coding software that improves reimbursement, compliance, and productivity is a priority for many medical groups. A recent survey of the …
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HCC Coding
March 18, 2021
Why Medicare Advantage Organizations Do Retrospective Chart Reviews to Improve RAF Scores (and What Medical Groups Can Learn from Them)
Medical groups face many challenges when it comes to risk adjustment—particularly regarding providers and coding. We often hear that providers are …
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Revenue Cycle
March 16, 2021
How Crozer Health Improved Efficiency and Reduced Denials
Crozer Health is a community-focused healthcare system in Delaware County, Pennsylvania. Since 2016, Crozer Health has been a part of Prospect …
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HCC Coding
March 2, 2021
3 Ways to Prioritize HCC Coding Review Opportunities in the New Year
The start of a new year brings with it a new set of challenges for Population Health Managers. All previously captured HCC codes are now potential …
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Revenue Cycle
February 23, 2021
Does Your Claim Scrubber Meet Your HCC Coding Needs?
As the healthcare industry shifts from fee-for-service to value-based care, revenue cycle and coding teams must adapt their processes and …
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Revenue Cycle
February 11, 2021
A New Level of Efficiency: How Peak Vista Eliminated Hours of Daily Claim Review
Peak Vista is a nonprofit federally qualified health center in Colorado with 188 providers serving over 94,000 patients through 27 outpatients …
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HCC Coding
January 26, 2021
How This ACO Improved Coder Productivity and HCC Accuracy
From Inefficient, Error-Prone, and Stressful to Smooth and Streamlined Arizona Community Physicians (ACP) is a leader in value-based care. Their …
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Revenue Cycle
December 22, 2020
Are You Billing Correctly for the New COVID-19 Vaccine? Here are 9 Ways to Ensure Proper Payment
The COVID-19 pandemic has led to a rapid change of billing requirements and the development of new codes, making an already tough job for revenue …
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HCC Coding
December 3, 2020
Fewer Patient Visits Due to COVID-19 Means Fewer HCC Opportunities
It is no secret that the COVID-19 pandemic has uprooted life in 2020. From rattling the economic landscape to transforming the way we gather with …
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HCC Coding
November 24, 2020
The 7 HCC Coding Review Opportunities You Don't Want to Miss
HCC coding review is a complicated process, and it’s easy for coding opportunities to slip through the cracks. When patient diagnoses aren't fully …
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Revenue Cycle
November 12, 2020
Claim Scrubber vs. Charge Scrubber: What's Best for Your Practice?
You may already be familiar with Claim Scrubbers. But did you know that claim scrubbers are no longer the only option for a practice looking to …
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Revenue Cycle
October 15, 2020
How This 400+ Physician Medical Group Redefined Efficiency by Embracing Automation
The old mantra: The more eyes, the better the results. This mantra guided Crystal Run Healthcare’s claims process for years. With 20 practice …
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HCC Coding
October 1, 2020
4 Steps to Maximize Value-Based Profitability: How One Clinic Captured Over $500K in RAF Value in Less Than 2 Months
Providing better care while reducing costs is no easy feat and ensuring profitability along the way requires strategic change. Many organizations …
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Revenue Cycle
September 17, 2020
COVID-19 Encounters: 5 Ways to Ensure Complete Payment for Testing and Diagnosis
The COVID-19 pandemic has led to new and rapidly changing coding/billing regulations, making an already tough job that much harder for revenue cycle …
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HCC Coding
September 3, 2020
Value-Based Care Comic Strips—with a Serious Message
If you haven’t seen any of the Doc-Related comic strips, you’re in for a good time. (And don’t we all need a little humor in this business?) They …
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Revenue Cycle
August 25, 2020
4 Ways to Ensure Accurate Payment for Telehealth Visits
The COVID-19 pandemic has led medical groups to expand telehealth services. Coding and billing regulations for these services are rapidly changing as …
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HCC Coding
August 5, 2020
How HCC Coders Benefit Your Bottom Line
Throughout the pandemic medical groups have seen patient volumes and elective services decline, causing significant decreases in revenue. This has …
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Revenue Cycle
July 28, 2020
Webinar on Demand: How RCM Leaders Can Do More—With Less
Leading a revenue cycle team is more challenging than ever before. As the COVID-19 pandemic continues to disrupt the healthcare industry, …
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Revenue Cycle
May 12, 2020
To the Other Heroes of Healthcare
Like so many others, we salute the doctors, nurses, and other medical workers on the front lines of the COVID-19 pandemic. Their dedication and …
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HCC Coding
May 8, 2020
CMS Policy Changes Supporting ACOs Impacted by COVID-19
CMS remains fully committed to the transition to value-based care and Accountable Care Organizations (ACOs) are a big part of this strategy. As a …
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Revenue Cycle
March 24, 2020
3 Ways to Make Your Revenue Cycle Team Happier in 2020
Managing a busy revenue cycle team while keeping morale and productivity high can be a real challenge—especially when the holidays are long gone and …
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HCC Coding
March 18, 2020
Learn How Top-Performing Organizations Improve RAF Score Accuracy—Free eBook
Wondering how to consistently achieve superior results under value-based and Medicare Advantage programs?
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HCC Coding
February 25, 2020
Improve Your HCC Coding Performance—with Play-Doh!
Throughout history, many of the greatest innovations happened either completely by accident or by taking a solution to an old problem and applying it …
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HCC Coding
January 31, 2020
HCCs and RAF Scores: A Two-Part Challenge
Medical groups throughout the country continue to make great strides in improving their clinical quality and documentation under value-based …
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HCC Coding
December 12, 2019
Is HCC Coding a Physician Problem?
Some organizations take the position that HCC Coding is exclusively the physicians' responsibility. We disagree, as doing this well, takes a village.
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HCC Coding
November 21, 2019
APG's 2019 Colloquium: A Recap from RCxRules
RCxRules recently attended America’s Physician Group’s (APG) Annual Colloquium conference in Washington DC. The focus of the conference was “Thriving …
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HCC Coding
October 9, 2019
How to Build a Scalable HCC Infrastructure [3 Best Practices]
Value-based reimbursement models and Medicare Advantage plans continue to gain momentum. Is your organization built to handle the growth of …
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HCC Coding
September 26, 2019
Q&A with a Pop Health Expert: Taking on More Risk
We were fortunate to speak with pop health expert, Kate Casaday, Population Health & Value-Based Lead at CareMount Medical, about best practices …
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HCC Coding
August 20, 2019
Why Are My RAF Scores Low?
What is a RAF Score? A RAF score, or risk adjustment factor score, is a medical risk adjustment model used by the Centers for Medicare & Medicaid …
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HCC Coding
July 16, 2019
3 Ways to Transition to Value-Based Reimbursement Without Hiring More Staff
While the fee-for-service model of care is based on quantity, value-based programs focus on quality and patient outcomes. Unfortunately, many medical …
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HCC Coding
June 18, 2019
HCC Coding: 4 Things the Most Successful Medical Groups Have in Common
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HCC Coding
May 30, 2019
3 Varieties of HCC Coding Review: Prospective, Concurrent, and Retrospective
Coding reviews are essential for financial success in value-based contracts. But what kind—or kinds—of reviews work best?
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HCC Coding
May 8, 2019
HCC Coding: An Effective Offense Starts with a Solid Defense
Most of us have heard the sporting maxim that “defense wins championships.” Why? Because a good defense not only manages (and helps minimize) …
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HCC Coding
May 2, 2019
Obervations from APG's 2019 Annual Conference
RCxRules was thrilled to have recently attended America’s Physician Group’s (APG) annual conference in San Diego. The focus of this mid-April meeting …
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HCC Coding
April 9, 2019
“We are the Champions” & Other Highlights from AMGA 2019
This year’s AMGA annual conference (#AC2019) was as entertaining and informative as any healthcare conference we have attended. Between Dr. Zubin …
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HCC Coding
April 2, 2019
RISE 2019: Notes & Observations
The RISE conference, held in Nashville from March 17-19, brings together the best and the brightest from the world of risk adjustment to share best …
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HCC Coding
March 19, 2019
3 Simple Steps to HCC Coding Success
To achieve financial success under today’s value-based programs, it’s imperative that your patients’ health status be appropriately risk adjusted—and …
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HCC Coding
February 28, 2019
Top 10 Most Common HCC Codes
Appropriate capture and documentation of HCC Codes for patients is critical for accurate risk adjustment scores. Understanding how the over 9,700 …
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HCC Coding
January 22, 2019
7 Tips to Close HCC Gaps and Ensure Complete Code Capture
Completely capturing and documenting Hierarchical Condition Category (HCC) codes for your attributed members is imperative to ensuring accurate risk …
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Revenue Cycle
December 18, 2018
Three Major Obstacles to RCM Efficiency—And How to Overcome Them
When it comes to running an efficient operation and ensuring full and prompt payments, even the best revenue cycle leaders and teams face significant …
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HCC Coding
November 29, 2018
HCC Coding Recapture = Low-hanging Fruit in Value-Based Reimbursement
The original meaning of low-hanging fruit refers to the sweet, easy-to-reach fruit at the lower end of a tree's branches. For obvious reasons, …
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HCC Coding
October 30, 2018
2018 Value-Based Care Summit: Key Takeaways
This October, RCxRules had the privilege of attending the Value-Based Care Summit in Boston. While the term ‘Value-Based Care’ encompasses many …
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HCC Coding
October 25, 2018
Observations from APG’s Value-Based Colloquium–Lead Dogs and the Third Option
“Lead Dogs” was a term Senator Sheldon Whitehouse used when opening America’s Physician Groups’ (formerly CAPG) Value-Based Colloquium in Washington …
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Revenue Cycle
September 20, 2018
6 Astounding Facts on Healthcare Administrative Costs
Healthcare administrative costs continue to surge in the U.S. making cost containment a stronger focus for healthcare leaders in 2018. In fact, here …
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Revenue Cycle
August 29, 2018
E&M Coding Changes to Watch in 2019
Once a year, the Centers for Medicare and Medicaid Services (CMS) reviews the physician fee schedule for desired modifications to take affect the …
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HCC Coding
August 20, 2018
2018 WRUG: What We Learned
The opening remarks by Kelly Robison, CEO of Brown & Toland Physicians, set the tone for this year’s WRUG (Western Region User Group for GE …
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Revenue Cycle
July 19, 2018
3 Ways to Survive Employee Turnover and Stay Profitable
Employee turnover is one of healthcare’s biggest challenges. A study by Compdata Surveys discovered the average turnover in healthcare jobs in 2017 …
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HCC Coding
June 19, 2018
Top 3 Challenges in Shifting to a Value-Based Payment Model
The shift from a fee-for-service reimbursement model to a value-based model is a not an easy one for providers, but it’s something more and more …
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Revenue Cycle
May 15, 2018
You've Probably Already Used AI a Few Times Today
When we think about Artificial Intelligence (AI) there’s a lot of hype and excitement. We often hear the questions, “How will AI affect us?” “How …
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Revenue Cycle
April 3, 2018
3 Reasons Why Artificial Intelligence is Critical to Optimizing Your Revenue Cycle Process Today
There’s no question that Artificial Intelligence (AI) has transformed other industries. And a lot has been written about AI’s very promising future …
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HCC Coding
September 1, 2017
Value Based Reimbursement - Simplified - Part 3
Part 3: Five Things Every Healthcare Organization Needs to Know about HCC Coding The Center for Medicare and Medicaid Services (CMS) first …
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HCC Coding
May 12, 2017
Value Based Reimbursement - Simplified - Part 2
Part 2: Risk Adjustment—How Medical Groups Get Paid While all value-based reimbursement models seek to provide appropriate care to patients while …
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HCC Coding
March 13, 2017
Value Based Reimbursement - Simplified
Part 1: Risk Adjustment Overview
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Revenue Cycle
January 11, 2017
3 Things an Industry Expert Wants You to Know – Chesapeake Urology
Has RCxRules' urology medical billing software affected your revenue cycle staffing requirements? If so, how? RCxRules has made our coders 33% more …
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Revenue Cycle
November 28, 2016
3 things an industry expert wants you to know - Physicians Resources LTD
How do you feel about the RCxRules company and team? The fact that we were one of the first customers to use RCxRules has allowed us the opportunity …
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Revenue Cycle
October 25, 2016
3 things an industry expert wants you to know – Women's Health USA
How do you feel about the RCxRules company and team? From the first meeting, through the contract negotiation, and more importantly, after using the …
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Revenue Cycle
October 7, 2016
2 Things an Industry Expert Wants You to Know – OrthoCarolina
Has RCxRules’ orthopedic medical billing software affected your revenue cycle staffing requirements? If so, how? More than anything, I'd say that …
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Revenue Cycle
September 20, 2016
3 things an industry expert wants you to know – SouthCoast Health
Has RCxRules’ automation capabilities affected your revenue cycle staffing requirements? If so, how? There are three main areas in which RCxRules has …
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Revenue Cycle
February 5, 2016
Does Your EMR System Have You Covered?
Probably not. Not for optimizing your financial performance, anyway. As we start 2016, it is clear that more and more provider groups are making the …
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Revenue Cycle
February 2, 2016
5 Reasons Why a Healthcare Security Officer is Critical for Data Security
In the new era of frequent cyber attacks, healthcare providers are finally stepping up to take an active role toward an increase in data security. …
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Revenue Cycle
January 20, 2016
Five Ways Automating Your Charge Review Process Benefits Your Revenue Cycle
Using Technology to Benefit Your Financial Outcomes Your healthcare organization is facing challenging times as it looks to optimize its revenue …
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Revenue Cycle
January 8, 2016
Not So Fast: Healthcare Undergoes ICD-10 Growing Pains
ICD-10 Is Not Going As Smoothly As We Originally Thought Last month we talked about how the implementation of ICD-10 appeared to be going well, …
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Revenue Cycle
January 6, 2016
More people with insurance: Good news, right?
Today in healthcare, with seemingly ever-changing reimbursement rates, ICD-10 complexities, the increasing prevalence of high-deductible health plans …
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Revenue Cycle
December 14, 2015
ICD-10 Holiday Cheer
By now we’ve likely all seen the book, Struck by Orca, in which a number of artists “representing a diverse background in healthcare” illustrated …
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Revenue Cycle
November 18, 2015
ICD-10 Denials: To This Point, Not So Bad
In the lead up to ICD-10, everyone wondered what the landscape would look like once October 1st arrived and in the subsequent weeks and months to …
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Revenue Cycle
November 16, 2015
What if there were no denials?
Really, think about it for a moment. What would it mean to providers if they were able to virtually eliminate both claim denials and slow/partial …
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Revenue Cycle
September 21, 2015
In healthcare, clean data drives everything
We’ve all been living with insurance claim denials for what seems an eternity. We have come to accept that a moderate denial problem is simply the …
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Revenue Cycle
August 27, 2015
Managing simultaneous ICD-9 and ICD-10 charge codes.
For providers large and small, the reality is that both before the Oct 1st deadline (when providers are phasing into ICD-10, yet payers still require …
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Revenue Cycle
August 26, 2015
The importance of establishing a joint Clinical and Revenue Cycle Project Management Office (PMO).
ICD-10 is both a clinical and revenue cycle challenge, and ensuring that these two critical functions react to the inevitable ICD-10 upheaval in a …
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Revenue Cycle
August 24, 2015
What does the CMS guidance on ICD-10 “flexibility” really mean to you?
There have been many headlines covering July’s joint ICD-10 announcement from the Centers for Medicare and Medicaid Services (CMS) and the American …
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