3Genconsulting

  In the healthcare industry, revenue cycle management (RCM) is a multifaceted process encompassing various financial activities, including medical billing, medical coding, and accounts receivable management. Compliance with regulatory standards and undergoing audits are essential components of revenue cycle management services, ensuring that healthcare providers adhere to legal and industry requirements. Healthcare organizations can rely on a revenue cycle management company like 3Gen Consulting to navigate these complexities and ensure compliance with regulatory expectations. This comprehensive guide delves into the significance of revenue cycle management compliance and audits, shedding light on the stringent requirements placed on providers and the pivotal role that a revenue cycle management company plays in supporting them. Furthermore, by understanding the importance of compliance and audits in revenue cycle management services, providers can proactively address regulatory cha

  Medical coding audits are critical to a healthy revenue cycle, but with all the options, it is difficult to know where to position the different types of medical coding audit services in your revenue cycle management optimization strategy. One of the most challenging can be the self-audit — an internal review that can be used with other medical coding audit services to optimize your revenue cycle results. What Are Self Audits? Self audits are a careful review of existing medical coding practices to help ensure compliance with medical coding and billing standards, rules, and regulations [1]. They can also be incredibly powerful tools of prevention. They allow providers to protect against lost revenue and billing issues by getting ahead of payer audits. They help you find payment, medical billing , and medical coding issues (including missed revenue), identify problems in patient care, flag opportunities for training, and get ahead of compliance issues. It’s important to view se

  Retrospective reviews of  risk adjustment coding  are foundational to the financial health and stability of Accountable Care Organizations (ACOs) and Medicare Advantage plans (MAPs). This is increasingly true as value-based contracts and their underlying details become more complex, coding requirements change, and the  demand for qualified  risk adjustment coders  increases. By focusing on retrospective reviews of   risk adjustment coding , you can position your organization for more accurate representation of your population and possibly better financial outcomes.  What is Retrospective Risk Adjustment Put simply,  retrospective risk adjustment  is looking back at past claims to ensure proper diagnosis coding. The benefit is that this process can reveal gaps in your diagnosis coding of chronic illnesses that could lead to decreased reimbursement in the future.  And while many ACOs and Medicare Advantage plans have a retrospective risk program, sometimes the plans themselves are inef