The RCxRules Blog

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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