RC Billing

This week is National Women’s Health Week, a reminder to focus on prevention, early care, and long‑term health for women at every stage of life. At R3source Health (RCCS, RC Billing, and Regents Health Resources), we work alongside healthcare organizations every day to support care that is proactive, coordinated, and built to last. When systems run well behind the scenes, providers can spend more time focusing on their patients; and that matters when it comes to improving access, outcomes, and overall women’s health. Women’s Health Week is an opportunity to step back and recognize the importance of thoughtful, connected care and the work it takes, across healthcare, to make that possible. #NationalWomensHealthWeek #WomensHealth #PreventionAndCare #HealthcareLeadership #PatientAdvocacy

Happy National Nurses Week! 🩺🤍 Across oncology, imaging, and everywhere in between, nurses are often the constant, coordinating complex care, supporting patients and families, and keeping teams aligned when the pace is fast and the stakes are high. We’re especially grateful for the oncology nurses who help keep treatment moving forward, and for imaging teams whose clinical vigilance supports safe, efficient diagnostics and follow‑up. Behind the scenes, nurses also play a critical role in documentation, communication, and care coordination, work that directly supports accurate coding, clean claims, and compliance across the care continuum. That’s why our teams at RC Billing, Regents Health Resources, LLC, and RCCS are proud to partner with nurses and the organizations they support every day. Thank you to the nurses who make care safer, clearer, and more sustainable for patients, care teams, and communities alike. #NationalNursesWeek #OncologyNursing #Imaging #Radiology #RevenueCycle #Documentation #Compliance #HealthcareOperations

This Oncology Nursing Month, we’re proud to recognize the oncology nurses who show up every day with skill, compassion, and resilience. From navigating complex treatments to supporting patients and families through some of their hardest moments, oncology nurses play a critical role in cancer care. At R3 (RCCS, RC Billing, & Regents Health Resources, LLC), we’re grateful to work alongside and support the teams who make this work possible. Thank you for the expertise, advocacy, and care you bring to every patient, every day. 💙 #OncologyNursingMonth #HealthcareHeroes #CancerCare #ThankYouNurses #OncologyCare

Attention Radiation Oncology in CA. We have been working on nationwide issues since January but we need help in Numbers to get further traction. The current response of, "it will be addressed in 2027" is NOT going to be helpful to many locations and truly puts access at risk for the most vulnerable population of patients. There is no single national payment average for Medicaid as the program is state specific. That said, there are MANY opportunities across the nation for involvement and awareness.  •CA – Medi-Cal which adjudicates Medicaid claims for payment in California as an example •The codes in question are –77387 – Currently recognizing $0 for payment to the Radiation Oncologist for IGRT services –77402 – Currently recognizing $42.40 –77407 – Currently recognizing $38.77 –77412 – Currently recognizing $43.20The codes in question are •By comparison, national Medicare benchmarks for these same services (updated effective January 1, 2026, under the revised CPT coding structure that bundles technical image guidance into the delivery codes) are substantially higher and reflect the true resources involved:  • CPT 77387 (professional component only): approximately $36.74 (Medicare PFS non-facility; commercial payers often reimburse $100–$130). • CPT 77402 (Level 1): approximately $79.49 (PFS non-facility) to $104.24 (HOPPS). • CPT 77407 (Level 2): approximately $317.64 (PFS non-facility) to $394.05 (HOPPS). • CPT 77412 (Level 3): approximately $391.46 (PFS non-facility) to $564.51 (HOPPS). Write to your local representative and get engaged. Contact me directly, if you want help with a letter or phone number to call. ron.digiaimo@rccsinc.com or my cell at 512-971-7724 text is best. thanks Ron RCCS R3source Health: RCCS | Regents | RC Billing

Attention Radiation Oncology in MA: This is yet another example of Medicaid issues in another state we are addressing and need help with regarding Numbers and attention. There are many more states to address but don't want to bomb your in boxes today... Yes, I'll continue to update :-) Payment Rate Examples MA Medicaid As per the Current Medicaid Payment Fee for Massachusetts Medicaid. Physicians in MA for Radiation Therapy Centers lists I.C. (Individual Consideration) for Treatment Delivery of 77402, 77407 and 77412 and IGRT 77387. I.C. Listed. This means that each code and physician practice is evaluated on a case-by-case basis as to whether it is payable or not and what amount if any is set. “MA Health determines payment rate on a case-by-case basis after reviewing provider’s documentation of services rendered.” Unless you are aware and involved and make it an issue, there is a possibility this comes out as zero which is a problem access wise to this group of patient population likely needing care the most of any payer group. Evaluation criteria – Time required, Degree of Skill required, Severity or Complexity of Patient’s condition and relevant invoices or Operative Reports. RCCS R3source Health: RCCS | Regents | RC Billing

Prior authorization has quietly become one of the most damaging bottlenecks in patient care. A radiology order gets written. Staff submit the documentation. The payer goes silent. The patient waits. The schedule stalls. And the revenue clock never even starts. CMS-0057-F is the first federal rule that actually takes direct aim at that problem. Starting this year, payers must issue standard prior auth decisions within 7 calendar days and urgent decisions within 72 hours. They are required to give a specific reason for every denial. And they have to publicly report their approval and denial rates. By 2027, they must build real electronic infrastructure that connects directly with provider EHR systems so that submissions and decisions stop living in fax queues and disconnected portals. For radiology and specialty care, the downstream impact on revenue cycle is significant. Authorization delays are not just a patient access issue. They are an accounts receivable issue. Every pending auth on an MRI, a PET scan, or a procedure is revenue that cannot even be scheduled yet. Faster decisions mean faster scheduling certainty and faster cash realization for practices that are built to take advantage of it. The rule does not fix everything automatically though. The providers who benefit most will be the ones who redesign their workflows around it now, not the ones waiting to see what payers do. CMS is creating the infrastructure. Whether it translates into real operational relief depends on how prepared your team is to use it. Abigail Lamb CalnonTammie MyersAshley Hunter, MBA, CHFP, CRCR