RCM Advisor Quarter 4 2025 - Volume 30, ISSUE 4 - Healthcare Business Management Association The non-profit membership association for healthcare revenue cycle management professionals

2025... and Looking Ahead

President's Message

By Kirk Reinitz, HBMA President

As we approach the final stretch of 2025, I am both proud and inspired by the tremendous progress our organization has made over the last several years.

SOUND OFF!

HBMA Members SOUND OFF! on industry topics

By RCM Advisor Editors

Topic: Tell us if you or your clients are using AI technology, and if so, what are the pros and cons?

Data That Matters: Fee Survey Participation Increase Signals Stronger HBMA Member Engagement

Spotlight On... Data Science Committee

By Ron Decker, Co-Chair & Karina Vega, Co-Chair

The Healthcare Business Management Association (HBMA) Data Science Committee is pleased to share the results of its most recent Fee Survey, an important milestone in the association’s commitment to providing meaningful, actionable insights to its members.

False Claims Act – It’s Not Just a Provider Problem

Why Third Parties Should Take Steps to Mitigate FCA Risk

By Erica Barnes, Esq.

If you own or work for a third party medical billing company or a company providing revenue management or other healthcare business services, you probably already know that your healthcare provider clients face a rising tide of FCA litigation relating to submission of incorrect claims to government payors

Protecting Your Company – Through Proper Client Contracts

Feature Story

By Jennifer Kirschenbaum, Esq.

When the value of your business is intrinsically tied to the contracts you hold, it is important to understand which of the key provisions protect your rights to revenue and your company’s revenue once earned.

High-Stakes Vendor Contracts

Play Smart, Win Big

By Mark Cunningham, Esq.

For many medical billing companies, entering into a key contract with a new vendor can feel like stepping into a high-stakes poker game. You hope to hold a winning hand, but the deck might be stacked against you.

The No Surprises Act and the Federal IDR

Relevant to Both In-Network and Out-of-Network Providers

By Thomas LeGreca, Esq.

Few developments over the course of the history of American healthcare are as impactful as the No Surprises Act (NSA), at least with respect to the insured community.

Counsel or Compliance

Understanding and Using Both in Healthcare Leadership

By Landon Tooke, Esq.

Can you draw a clear line between compliance and legal in your organization, or do their functions seem interchangeable? It is a common misconception, even among experienced leaders, that legal and compliance serve identical roles

Why the 2026 Medicare Physician Fee Schedule (PFS) Is More Impactful than Recent PFS Proposed Rules

Government Affairs

By Matt Reiter

On July 14th, the CMS published the... 2026 Medicare PFS proposed rule. This 1,800-page document outlines payment policy changes for physician services reimbursed under the PFS.

Cybersecurity 101: Remote Workers

Compliance Issues

By Nicole Statley, CPCO, CPMA, CPC

Implementation of electronic health records and cloud-based systems paved the path for remote workers in healthcare billing and administration. Organizations began seeing benefits such as lower operation costs and higher productivity with a remote workforce.

How to Avoid the 'I Found Your iPhone in China' Scam

The Tech Guy

By Burton Kelso

Having your iPhone stolen is incredibly stressful, and dealing with scammers afterwards only adds to the burden. While activating Apple's “Find My” feature is the correct step to prevent thieves from using your device, it can unfortunately open a door for them to contact you directly.

Big Changes for 2026

Coding Corner

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

The AMA has released the 2026 CPT® coding updates, marking one of the most expansive revisions in recent years. These changes reflect the rapid evolution of clinical practice, the integration of digital health technologies, and the need for greater specificity in procedural reporting.

Developing a Winning Proposal for Medical Billing Services

From the Road

By Dave Jakielo

A winning proposal for providing medical billing services should be comprehensive, clear, and tailored to the specific needs of the potential client. Here are some recommended characteristics and components that should be included....

Quarter 4 2025 - Volume 30, ISSUE 4