Surgical procedure denials, particularly during the global period, can create substantial obstacles for healthcare practices—disrupting revenue flow and causing administrative headaches. In our recent webinar, we addressed these challenges head-on, providing solutions to help you manage denials and ensure accurate reimbursement. ​

​As healthcare continues to evolve, so too do the models that determine how providers are reimbursed for their services. With an increasing shift from procedure-based payments to those that rely heavily on diagnosis coding, ensuring your practice is prepared for these changes is essential for long-term success. The ICD-10-CM diagnosis code set, once considered secondary to procedure codes in reimbursement, is now playing a more central role, making precise documentation critical.

​RCCS President Melody W. Mulaik, MSHS, and Director of Revenue Cycle Consulting Mary Early Suhr, MBA, CPC recently presented a webinar tackling the timely topic of revenue recovery. This article provides a recap of the presentation and additional resources to help your organization identify and recover missing revenue. 
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RCCS is honored to spotlight Ashley Mulaik Hunter, Manager of Financial Analytics, as she prepares to present at the distinguished RBMA PaRADigm 2024 conference later this month. In her session, “Proactive Process Improvements with Data Analytics,” Ashley will provide an expert analysis on leveraging data analytics to enhance the efficiency and effectiveness of healthcare practices, particularly through minimizing denials.

​​With a career dedicated to the intersection of healthcare finance and technology, Ashley Mulaik Hunter has consistently been at the forefront of identifying and implementing innovative solutions for optimizing revenue cycles across various healthcare settings.

Preparing for a successful 2024 requires a proactive approach to healthcare operational excellence in the face of evolving challenges. In the dynamic healthcare landscape, successful organizations prioritize adaptability and strategic foresight. Whether through a comprehensive revenue cycle assessment or targeted coding education, forward-thinking healthcare entities are investing in strategies to optimize financial performance and cultivate a culture of continuous improvement. This article explores RCCS’ solutions for success, emphasizing the significance of professional assessments and training initiatives in navigating the complexities of the upcoming year.

By: Juan Arredondo and Bri Driggers
Medical coding serves as the backbone of healthcare reimbursement and compliance. Accurate coding ensures that healthcare providers receive appropriate reimbursement for services rendered and adhere to regulatory standards. In the realm of medical coding, one indispensable tool is the modifier. 
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Medical coding modifiers are alphanumeric characters added to procedure codes to provide additional information about a service or procedure. This article explores the definition of modifiers in medical coding, why they are vital, and when and how to employ them effectively.

By: Ashley Mulaik, MBA, and Bri Driggers

In 2020, over half of the working physicians in the United States worked for private practices. These practices are wholly owned by physicians rather than hospitals, health systems, or other third parties.
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There are several reasons why physicians might choose private practice over a larger healthcare system, particularly the chance for more autonomy and less bureaucracy. Partners at a practice work together to make decisions about processes and services democratically based on what they think is best for their patients rather than being told what to do by a higher-up.

By: Briauna Driggers and Juan Arredondo

Regulations are crucial in promoting ethical and responsible business practices while safeguarding consumers, workers, and the public. In the healthcare industry, adherence to regulations is paramount, as non-compliance can have severe consequences, risking patients' lives and financial integrity.
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Compliance programs are essential tools that healthcare organizations utilize to ensure adherence to relevant laws and regulations, preventing fines and legal actions. A proactive compliance program is designed to detect and correct infractions swiftly, promoting patient well-being and organizational sustainability.

Republished with permission. © Relias. Originally written in April 2023 by Stacy Kusterbeck 
Edited by: Briauna Driggers

​​The healthcare industry is ever-changing, with an extremely complex revenue cycle process. Healthcare leaders face constant updates in regulations, billing rules, payer requirements, and technology. More likely than not, your staff needs continuous training to keep up with these important changes.

By: Ron DiGiaimo, MBA, FACHE and Briauna Driggers

Healthcare has made a major impact on our country’s economy, and it is interesting to see how cancer care fits into that picture.  There are many moving parts to the oncology portion of healthcare economics; medical oncology and the associated high-cost drugs, surgical oncology, and radiation oncology being the most known and utilized.  We quickly recognize that Radiation Oncology has the lowest number of practicing physicians nationally of those three specialties.