3Gen Consulting

09/17/2026

CMS imposed a nationwide moratorium on new home health agency enrollment on May 13, 2026.

If your agency is already enrolled, you can still operate. But here's what CMS said it would do during the six-month window:

— Intensify targeted investigations into HHAs
— Deploy advanced data analytics to identify fraud-linked billing patterns
— Expand pre- and post-claim review in Florida, Illinois, North Carolina, Ohio, Oklahoma, and Texas

That last point affects existing agencies directly. Pre- and post-claim review means CMS is reviewing whether your documentation supports what you billed – before or after payment. Under PDGM, where the HIPPS code and reimbursement rate are driven entirely by OASIS documentation, that review has very specific implications for coding accuracy.

The enforcement environment that triggered this moratorium is now more active than ever. The question for every enrolled agency is whether its billing and documentation infrastructure is ready for closer scrutiny.

🔗 https://bit.ly/4Abe3s2

CMS imposed a nationwide moratorium on HHA enrollment in May 2026. Here's what it means for existing home health billing services and what agencies need to do now.

09/16/2026

Denial management gets a lot of attention.
Denial prevention doesn't get enough.

The math is simple: it costs significantly more to work a denied claim than to prevent the denial in the first place.

And 65% of what gets denied never comes back at all.

At 3Gen Consulting, prevention is the strategy - not the afterthought.

📞 (888) 886-3436
🌐 https://www.3genconsulting.com/outsourcing-accounts-receivable/

09/15/2026

A provider who can't bill is a provider who can't generate revenue - no matter how many patients they see.

Credentialing feels administrative until it becomes a cash flow crisis.

At 3Gen Consulting, we manage provider enrollment as a revenue protection process - not a back-office checklist.

📞 (888) 886-3436
🌐 https://www.3genconsulting.com/provider-credentialing/

09/14/2026

May this festival bring wisdom, new beginnings,
and the removal of every obstacle.

Ganpati Bappa Morya! 🙏✨

09/13/2026

Lymphoma. Leukemia. Myeloma.
We honor their strength.

09/12/2026

CO-4 is one of the most common - and most preventable - denial codes in medical billing.

It means the modifier attached to the procedure code doesn't align with how the payer expects that service to be billed.

The fix isn't in the appeal. It's in the coding workflow.

At 3Gen Consulting, we help organizations fix the source - not just the symptom.

📞 (888) 886-3436
🌐 https://www.3genconsulting.com/medical-coding-services/

09/11/2026

If this made you laugh - you've been in this industry long enough to have a story.

The revenue cycle is genuinely complex. The teams navigating it deserve a lot more credit than they get.

Have a great weekend. 💪

📞 (888) 886-3436
🌐 https://www.3genconsulting.com/rcm-in-medical-billing/

09/10/2026

The future of HCC risk adjustment is no longer about diagnosis volume alone.

In 2026, Medicare Advantage plans, provider groups, and payers are shifting toward defensible coding strategies built around documentation integrity, audit readiness, and operational sustainability.

Our latest article explores:
- Why CMS-HCC Version 28 is reshaping RAF strategy
- What RADV auditors are really looking for
- Why HEDIS and risk adjustment are becoming operationally connected
- How AI-assisted visibility is supporting smarter workflows

🔗 Read the full article here: https://bit.ly/4xmotlZ

Explore how defensible HCC risk adjustment coding improves RAF accuracy, audit readiness, and HEDIS visibility for Medicare Advantage organizations.

09/09/2026

PAMA isn't just a reporting exercise. It's a reimbursement shaping event.

The data submitted this summer will directly influence Clinical Laboratory Fee Schedule rates effective January 1, 2027 - with up to 15% annual cuts possible through 2029.

For clinical labs and pathology groups, coding accuracy and clean claim rates matter more than ever.

At 3Gen Consulting, we help labs build revenue cycles that hold up when reimbursement tightens.

📞 (888) 886-3436
🌐 https://www.3genconsulting.com/lab-revenue-cycle-management/

09/08/2026

Most denial management programs fix the wrong problem.

They optimize appeals. Track denial rates. Measure days to resolution.

But the denial was already baked in at registration, documentation, or prior auth - long before billing ever saw the claim.

At 3Gen Consulting, we work upstream. Because that's where the real money is.

📞 (888) 886-3436
🌐 https://www.3genconsulting.com/outsourcing-accounts-receivable/