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RCM Advisor

Quarter 2 2024 - Volume 29, ISSUE 2

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AI is Here to Stay – What Will You Do?

President's Message

By Kyle Tucker

With social media’s advanced algorithms reinforcing our existing beliefs, we don’t seem to have the mechanisms in place to distinguish fact from fiction, what is true and what is false.

Unlocking Revenue Cycle Excellence: HBMA's New Learning Platform

Around the HBMA

By Jennifer Leo, Events and Affiliations Director, RCCS

The HBMA is thrilled to announce a groundbreaking development for its members.

SOUND OFF!

HBMA Members SOUND OFF! on industry topics

By RCM Advisor Editors

TOPIC: What types of monthly reports do you and your clients find most useful and informative?

Spotlight on the Innovation Committee

Around the HBMA

By Kunal Jain, Chair

This article delves into the why, what, and how of establishing this committee, emphasizing the role of AI and ChatGPT in fostering innovation within the industry.

Data Science Committee Denials Survey Results

Around the HBMA

By Sean McSweeny, Member, Data Science Committee

We asked HBAM Members the following questions regarding claims denials...

HBMA 2024 Spring Innovation Conference – SNAPSHOTS!

Around the HBMA

By HBMA

Photo wrap-up from HBMA's inaugural Innovation Conference in Tucson, March 5-7.

Revolutionizing Claims Management

Feature Story

By Andrew Harding

In today’s turbulent healthcare industry, revenue cycle management (RCM) teams grapple with the persistent challenges of claim denials. With denial rates on the rise, financial leaders are under increasing pressure to identify problem areas and reduce denial rates.

The Corporate Transparency Act

Feature Story

By Mark Cunningham, Esq.

The new law every billing company should understand.

Beyond Algorithms

Feature Story

By Landon Tooke, JD, MLS, CHC, CCEP, CPCO

Understanding liability issues in AI's healthcare revolution.

Follow Principles in 6 Key Areas to Protect Employed Physicians

Feature Story

By Timothy M. Smith / Reprinted from the American Medical Association

With the majority of physicians now employed by hospitals or health systems, fresh attention should be given to the challenges they face.

TED TALK: Is Remote Work Better Than Being in the Office? It’s Complicated

Feature Story

By Mark Mortensen

Opinions about remote work are plentiful and conflicting – but what does the research say?

Unpacking CMS’ Final Rule on Prior Authorization

Government Affairs

By Matt Reiter

On January 17, 2024, the CMS published its much anticipated final rule on how MA plans, Medicaid plans, CHIP plans, and ACA plans sold on the federal exchange can use prior authorization.

Spotlight on Malicious Insiders and Cybersecurity

Compliance Issues

By Chad Schiffman

The rise of malicious insiders poses a significant threat to organizations, as individuals with such knowledge can exploit their access for personal or monetary gain.

Tech Resolutions Everyone Needs to Make Throughout 2024

The Tech Guy

By Burton Kelso

Let’s face it, 2023 was a tough one. Many of you were looking for that fresh start this year, so even though you have resolved to make positive changes to your personal life, let’s also take a moment to add some for your digital life.

Behind the Scenes: A High Flyover of Crafting and Approving CPT® Procedure Codes

Coding Corner

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

Before a code graces the pages of the Current Procedural Terminology (CPT®) book, it undergoes a meticulous journey. Let's explore the code creation and approval process, demystifying the path from concept to inclusion.

Managing Virtual Teams

From the Road

By Dave Jakielo

COVID-19 changed our business lives forever. We now live in the world of Zoom, Microsoft Teams, Go to Meeting, etc. Who would have ever thought that most of our team members would be working from home?

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