The RCxRules Blog

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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