Leading the Business of Healthcare
RCM Advisor

Quarter 1 2024 - Volume 29, ISSUE 1

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Moving HBMA Into the Future with AI

President's Message

By Kyle Tucker

As HBMA enters 2024, our industry faces a seismic shift with the introduction of Artificial Intelligence (AI). Our primary expenses in the RCM industry are employee costs, which hover around 50%-60% of gross revenue.

Meet HBMA’s New President

Around the HBMA

By RCM Advisor Editors

Kyle Tucker, the newly appointed president of HBMA, is no stranger to the intricacies of this dynamic field.

Spotlight on the Compliance & Ethics Committee

Around the HBMA

By Nadine Smith, Chair

The Compliance & Ethics Committee assesses, investigates, and, when appropriate, renders a determination on allegations of violation of HBMA’s Code of Ethics.


HBMA Members SOUND OFF! on industry topics

By RCM Advisor Editors

TOPIC: As an RCM company owner or manager, what are your biggest challenges and how do you address them?

Data Science Committee Survey Results

Around the HBMA

By Curt Cvikota, Chair

This year the Data Science Committee committed to conducting and publishing a regular cadence of surveys. Our goal is twofold: 1) adhere to our charter of gathering benchmarking data for our membership and, 2) engage HBMA members to participate in these surveys.

HBMA 30th Anniversary RCM Conference


By RCM Advisor Editors

30th Anniversary HBMA energy at the 2023 Fall Conference in photos.

The Importance of Interoperability Standards and AI in the Healthcare Revenue Cycle

Feature Story

By Laxmi Patel and John Hataway

The future of the healthcare revenue cycle involves leveraging emerging technology while maintaining the human-centric element of healthcare.

Navigating the Evolving MIPS Landscape

Strategies for 2023 and Beyond

By Stacey LaCotti

Since the launch of the Quality Payment Program (QPP) in 2017, clinicians have struggled to keep up with the ever-evolving Merit-based Incentive Payment System (MIPS). Many clinicians are hoping if they wait long enough, CMS will discontinue the program altogether.

Embracing the Digital Revolution

Navigating the New Era of Healthcare Revenue Cycle Management


As we witness the dawn of a new age in healthcare, the traditional paradigms of revenue cycle management (RCM) are undergoing a seismic shift.

A Hacking Horror Story

Feature Article

By Cindy Groux

Have you ever answered the phone and known that it wasn’t good news, even while the phone was still ringing? That is how I felt on Sunday, July 2, 2023.

Cigna’s Modifier 25 Policy Burdens Doctors and Deters Prompt Care

Feature Story

By Kevin B. O’Reilly, News Editor / Reprinted from the AMA

In May, Cigna announced it was delaying implementation of its planned modifier 25 policy. In addition to reevaluating the policy, Cigna reported that it intends to “optimize the provider experience and perform additional provider education in partnership with key national medical associations.”

Congress is Considering Changes to the Physician Fee Schedule Budget Neutrality Requirement

Government Affairs

By Matt Reiter

There has been growing recognition in Congress that Medicare reimbursements to physicians are inadequate when compared to rising costs and the multitude of unfunded regulatory and administrative mandates from commercial and government payors.

Important Medical Records Retention Requirements for Billing Companies

Compliance Issues

By Chad Schiffman

During a session at the HBMA Fall Conference in Indianapolis, a question was asked about the Centers for Medicare & Medicaid (CMS) record retention requirements.

How To Know If You’ve Been Hacked or If You’re Being Paranoid

The Tech Guy

By Burton Kelso

In recent months, I have been getting a steady stream of phone calls, having real-life conversations, and receiving social media messages from people wondering if they have been hacked.

The Cat Is On the Roof

Coding Corner

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

We all deal with change differently. The speed with which we accept and embrace change varies significantly from person to person.

What Lies Ahead… My Predictions for 2024

From the Road

By Dave Jakielo, CHBME

Contrary to the rumors that have circulated over the past few years, medical billing companies will not become obsolete.

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