Shawntea "Taya" Gordon, MBA, FACMPE

On March 13, 2026, the Maryland Insurance Administration (MIA) fined Cigna $80,000 and ordered the insurer to stop automatically downcoding evaluation and management (E/M) claims. Read More ›

Imagine you are a healthcare provider seeing a complex patient with symptoms that could point to hundreds of conditions. Read More ›

The only tried and true method to achieve and maintain a successful revenue cycle is through the careful creation of a strong foundation alongside attention to the entire cycle. Read More ›

Successful revenue cycle management is a team effort that requires continuous collaboration across multiple departments of an organization. Although all institutions aim for standard industry best practices, the way in which these goals are attained may vary greatly, based on unique workflows, workforces, and needs. Read More ›

It is common for employees in the healthcare industry to begin their careers in entry-level positions and then move on to other positions as they acquire on-the-job training and experience. However, additional education and training is often necessary to ensure that their skills match an organization’s goals and requirements. These needs can be addressed through skills gap assessments and training. Read More ›

The Public Health Emergency (PHE), which has been in place since January 27, 2020, is going to end, although the official expiration date has not yet been determined. Many of the regulations built into 2022 final rulings from the Centers for Medicare & Medicaid Services (CMS) tied changes to the expiration of the PHE. Read More ›

Claim denials can have a significant negative impact on a medical practice, and the management of these denials remains an essential component of any solid revenue cycle plan. It is impor­tant to point out that this involves more than just resubmittals and appeals; practices should aim to prevent as many denials as possible from the start and then efficiently manage the ones that could not be prevented. In this article, I will discuss how grouping denial codes can provide valuable data that can be used to adopt a prevention-focused claim denials management process. Read More ›

The No Surprises Act, which went into effect on January 1, 2022, provides balance billing protections for patients while simultaneously creating new ways for them to understand their financial responsibilities. Read More ›

There is no doubt that the COVID-19 pandemic required practice managers and staff to rapidly develop and adopt innovative solutions to ensure the continuation of care for their patients. Like so many providers, I am certain that you and your colleagues rose to the challenge, and I applaud you for all that you have done! As you move forward, it is critical to remain up to date on important guideline changes and legislative updates to help your practice operate as smoothly as possible. Read More ›

On August 17, 2020, the Centers for Medicare & Medicaid Services (CMS) published its proposed plans for payment and reporting changes for 2021. In contrast to previous years on record, the final rule is likely to be released in early December instead of early November. This means that there may be less than 30 days to prepare and implement changes prior to January 1, 2021. Read More ›