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RCM Advisor

Quarter 3 2025 - Volume 30, ISSUE 3

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Innovation in the RCM Industry Is Here to Stay!

President's Message

By Kirk Reinitz

As I reflect on this year’s HBMA Innovation Conference, I am thrilled about the conference’s overwhelming success. This year’s gathering was the most well-attended Innovation Conference in our association’s history and the most transformative.

SOUND OFF!

HBMA Members SOUND OFF! on Industry Topics

By RCM Advisor Editors

Topic: Tell us whether your staff work in-house, remotely, or in a hybrid model and if you plan to make any changes.

Building Bridges with Payors: The Commercial Payor Relations Committee’s Mission and Momentum 

Spotlight On... Commercial Payor Relations Committee

By Olga Khabinskay, Vice-Chair

The HBMA CPR Committee plays a vital role in advocating for the interests of HBMA members in their dealings with commercial insurance companies. This committee bridges healthcare RCM companies and major commercial payors, working to reduce administrative burdens and improve reimbursement processes across the industry.

The Timely Filing Myth

Feature Story

By Don Self, CPC, CMCS, CASA

There is no shortage of myths that get passed around from generation to generation. Remember being told not to swallow gum because it would stay in your stomach for seven years?

The Impact of NCDs, LCDs, and Policy Articles on Claim Denials

Strategies for Proactive Management

By Virginia Norvell, MBA

Revenue Cycle Management (RCM) companies should continually assist their clients in understanding the reasons behind specific claim denials and ways to proactively prevent and resolve them.

Looking Back at the First 100 Days of the Trump Administration's HHS

Feature Story

By Luke Schwartz

Dating back to President Franklin Delano Roosevelt’s first term in 1933, a president’s first 100 days in office have remained a significant benchmark for every presidential administration. On the campaign trail, presidential candidates make promises for what they plan to achieve during their first 100 days if elected as president.

Revenue Cycle KPIs

What They Mean and How to Improve Them

By Randi Tapio, MBA, CMRS, CCCES, CPCS, CHM, CHBP

A well-managed revenue cycle is essential for maintaining a financially stable healthcare practice. But how do you measure success?

Patients’ Stories Push Lawmakers to Act on Prior Authorization

Feature Story

By Tanya Albert Henry

Critical changes are needed to fix the time-wasting, care-delaying payor process. Highlighting prior authorization’s patient impact goes a long way.

Checking In on Implementation of the No Surprises Act

Government Affairs

By Matt Reiter

The No Surprises Act (NSA) is arguably the most impactful legislation to the Revenue Cycle Management (RCM) industry since the Affordable Care Act (ACA).

The Status of Proposed HIPAA Rules: What HBMA Members Need to Know

Compliance Issues

By Chad Schiffman

As the healthcare industry, including billing and administrative areas, continue to evolve, proposed changes to HIPAA regulations can impact how organizations manage patient information, billing processes, and compliance obligations.

How To Protect Yourself from Clickjacking Scams

The Tech Guy

By Burton Kelso

You click buttons when you visit websites daily – to share, buy, and interact. But what if those clicks were not going where you thought they were? Welcome to clickjacking...

AI and Coding

Coding Corner

By Melody W. Mulaik, MSHS, CRA, RCC, RCC-IR, CPC, COC, FAHRA

AI has been around for many years in the practice of medicine, especially in certain specialties like radiology and cardiology. From a clinical to an efficiency perspective, it has been, and continues to be a hot topic for discussion.

Change Is Inevitable

From the Road

By Dave Jakielo

...the healthcare system in our country is so dysfunctional that it cannot sustain itself and radical change will have to occur if it hopes to remain operational.
Quarter 3 2025 - Volume 30, ISSUE 3 Cover
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Innovation in the RCM Industry Is Here to Stay!
Building Bridges with Payors: The Commercial Payor Relations Committee’s Mission and Momentum 
The Timely Filing Myth
The Impact of NCDs, LCDs, and Policy Articles on Claim Denials
Looking Back at the First 100 Days of the Trump Administration's HHS
Revenue Cycle KPIs
Patients’ Stories Push Lawmakers to Act on Prior Authorization
Checking In on Implementation of the No Surprises Act
The Status of Proposed HIPAA Rules: What HBMA Members Need to Know
How To Protect Yourself from Clickjacking Scams
AI and Coding
Change Is Inevitable
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