Leading the Business of Healthcare
RCM Advisor

Quarter 3 2023 - Volume 28, ISSUE 3

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Revolutionizing Medical Billing

President's Message

By Landon Tooke, CPCO, CHC

Medical billing, a critical and complex component in the healthcare industry, often presents as an intricate puzzle to both healthcare providers and patients. On one side, healthcare providers dedicate their time and skills to deliver essential services.

Spotlight on the Certification Committee

Around the HBMA

By Susan Bailie, CHBME, Chair

HBMA developed the CHBME program in 1994 to encourage billing and management professionals to continuously update their knowledge base of the complicated governmental regulations and business requirements of the healthcare billing industry.


Topic: Share with us your best practices on dealing with inconsistent information from payors and getting issues resolved.

By RCM Advisor Editors

Topic: Share with us your best practices on dealing with inconsistent information from payors and getting issues resolved.

Owners & Managers Spring Meeting Wrap Up

Around the HBMA

By RCM Advisor Editors

Photo highlights from the Spring 2023 O&M Meeting in scenic Dana Point, California.

HBMA Provides Feedback to the GAO for the Independent Dispute Resolution Implementation Report

Around the HBMA

By Matt Reiter

On April 26th, HBMA participated in a meeting with the GAO to provide feedback on the No Surprises Act (NSA) Independent Dispute Resolution (IDR) process.

HBMA 2023 Fall Revenue Cycle Management Conference Preview

September 26-28, 2023


HBMA's annual Revenue Cycle Management conference is back and celebrating our 30th year! Join HBMA's current leadership and past presidents for an event to remember!

Addressing RCM Challenges Through Incentive Based Staffing Models and Workforce Automation

Feature Story

By Matt Seefeld

Financial and operational challenges are plentiful within today’s healthcare organizations. Consequently, billing companies are feeling the pain downstream as provider margins are squeezed. 

The Adaptation Imperative

Considering Artificial Intelligence in the RCM Industry

By Jeff Hillam

Is it imperative that RCM businesses adapt to the future of Artificial Intelligence (AI), Robotic Process Automation (RPA), and machine learning? For RCM billing owners, this includes reviewing AI tools, RPA, machine learning, predictive analytics, and other new coding tools coming to market every year.  

Creating Harmony and Engagement in Your Medical Billing Company

Feature Story

By Gregory Offner

In the world of choral music, success comes not from the power of individual voices but rather from the collective harmony and coordination of all its members... This is not dissimilar to the challenges and opportunities that healthcare managers face when trying to cultivate an engaged and committed workforce. 

Artificial Intelligence Deepfake Video Scams

How to Protect Yourself

By Burton Kelso

Deepfake or synthetic videos are a scary new form of technology that criminals use to commit blackmail and identity theft cyber scams. Deepfakes have been around for a while, with people using them for entertainment purposes...

Access Wars in Healthcare

Feature Story

By Michael N. Brown

This article will explore a new paradigm developing within the universe of the patient/provider experience, and how healthcare providers and organizations are responding to compete for market share.  

The Impact of Prior Authorizations on Patient Care

Press Release

By Reprinted from the American Medical Association

New AMA survey results illustrate a critical need to streamline the prior authorization process and eliminate low-value requirements to minimize waste, delays, and disruptions in care delivery.

Medicare Site-Neutral Payments are Back on the Table

Government Affairs

By Matt Reiter

Site-neutral payments for outpatient services have resurfaced as a potential bipartisan priority for Congress. This is the most significant legislative activity on this topic since Congress passed legislation that would reduce payments for off-campus hospital outpatient departments established after the legislation became law in 2015.

Opportunities and Challenges for Medical Billing Companies with Artificial Intelligence

Compliance Issues

By Chad Schiffman

There are several opportunities and areas within the healthcare industry where artificial intelligence (AI) is rapidly growing. For example, Microsoft and Epic recently announced plans to integrate generative AI into Epic’s electronic health record (EHR) software.

How Ending the Public Health Emergency Impacts Providers

Coding Corner

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

After three long years, the COVID-19 Public Health Emergency (PHE) officially ended on May 11, 2023. This ending starts the transition back to many pre-COVID regulations; some went into effect immediately on May 12th, while others will phase out at the end of 2023 or 2024.

Fixes for Healthcare: Part Two

From the Road

By Dave Jakielo

In my article in the January issue of RCM Advisor, I outlined four ideas that could help streamline our complex healthcare system. In this article, I have some additional recommendations to lower costs, bring further efficiencies to the system, and reduce administrative burdens.

HBMA Vendor Directory

Around the HBMA


Current list of all HBMA Vendor Members.

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