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From Awareness to Action: September Insights from MRCS
- 11 minutes ago
- 6 min read
We hope you enjoyed the summer and are welcoming September with renewed focus and energy.
September is recognized across healthcare as a month of awareness, prevention, and advocacy. It also marks a natural shift from summer planning to fall preparation—a good time to refocus, review priorities, and make sure your organization has a strong game plan for the remainder of the year.
This month, we’re sharing key September deadlines, October 1 readiness updates, educational opportunities, and recent MRCS highlights to help your organization turn awareness into meaningful action.
We begin by recognizing several September observances that are especially meaningful across healthcare. |
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🔔 Immediate Action Items for September |
Several September deadlines and upcoming operational changes require attention. Organizations should prioritize the items that apply to their services, reporting requirements, and payer relationships.
Organizations participating in CAHPS for MIPS must complete survey vendor authorization by September 9. Comments on the CY 2027 Physician Fee Schedule proposals are due September 14. Proposed changes could affect same-day E/M payments, G2211 reporting, remote monitoring, and practice-expense methodology.
CMS expects to release 2025 MIPS final scores in late September. Review your results promptly and request a Targeted Review if needed.
Review the new ICD-10 files, HCPCS updates, Medicare NCCI edits, Medicaid NCCI edits, and laboratory and CLIA changes. Update systems, claim edits, and staff guidance before October 1, as applicable.
Log in to QPP to review payment details. If an expected payment was not received, check the 2026 QP Notice for APM Incentive Payment (ZIP) and submit updated Medicare billing information by October 13 if listed.
Prepare for updated batching requirements applying to disputes with open-negotiation periods beginning on or after November 1. Payers should also review the CARC and RARC guidance, which applies to items and services furnished on or after January 1, 2027.
📍 Maryland Medicaid Provider Alert
Register for available training, monitor outstanding enrollment activity, and prepare for Maryland Medicaid’s transition from ePREP to MPRIME, currently targeted for October 13, along with the end of current application holds.
🧾 Payer Alerts
Beginning October 1, affected outpatient UB-04 claims from in-network facilities must include appropriate CPT/HCPCS codes with identified revenue codes to qualify for reimbursement. UnitedHealthcare is also eliminating 30% of prior authorization requirements for most plans. Review affected services and update billing and authorization workflows accordingly.
Prepare for October 1 commercial changes involving prior authorization, site-of-care, and preferred drugs. CareFirst CHPMD providers should also be ready to submit medication prior authorization requests electronically through CareFirst Direct.
Review applicable October 1 commercial and Medicaid changes involving after-hours reimbursement, modifier 25, Excludes1 coding, and medication authorization and step therapy. Confirm electronic claims and payment arrangements before administrative fees may apply to certain paper-based transactions beginning November 1.
Addressing these items now can help organizations meet upcoming deadlines, support accurate reimbursement, and reduce avoidable claim and payment disruptions. |
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🔍 Key CMS & Industry Updates |
Beyond the immediate deadlines outlined above, several broader developments may influence longer-term planning and operations.
CMS continues moving clinicians toward greater use of MIPS Value Pathways and has released an MVP Transition Toolkit for Small Practices. Practices should begin assessing applicable pathways, measures, workflows, and data needs.
HHS-OIG identified concerns involving post-acute prior authorization denials, including a 95% overturn rate for appealed skilled nursing facility denials. Organizations should closely track denials, documentation, appeals, and payer-contractor activity.
CMS released Part 1 and Part 2 of coding revisions affecting National Coverage Determinations beginning January 1. Organizations should identify applicable changes and plan system testing and staff education.
CMS’s temporary program provides eligible Medicare Part D beneficiaries access to select GLP-1 medications for weight management. Prescribers should review eligibility, prescription instructions, and prior authorization workflows because the program operates outside standard Part D processing.
Maryland awarded $80 million to 41 grantees to expand primary, behavioral, and dental care. A separate $122 million federal investment in Virginia will support rural access, workforce development, virtual care, mobile clinics, and innovation. Organizations should monitor implementation and potential partnership opportunities. |
💡 MRCS Revenue Cycle Quick Tip |
New this month, we’re introducing a brief, practical takeaway designed to help your organization strengthen everyday revenue cycle operations. |
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🌟 Celebrating Two Years with MRCS |
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This September, MRCS is pleased to celebrate Ashley’s second anniversary with the team. As our Senior Dental Billing & Coding Advisor, she brings more than 15 years of experience helping dental organizations navigate insurance complexities, strengthen claims and coding processes, prevent denials, and improve reimbursement.
We are grateful for her expertise, dedication, and continued contributions. Congratulations on two years with MRCS! |
📚 Learning & Professional Development |
Build your knowledge and strengthen your skills through the MRCS Learning Center, offered in partnership with the Practice Management Institute (PMI). |
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🌟 From Practice Performance to Public Health |
August gave MRCS President and CEO Kem Tolliver two exciting opportunities to turn knowledge into action—sharing practical revenue cycle strategies with healthcare leaders and encouraging students to explore the growing field of public health technology. |
 🎥 Future-Proofing Your Practice
In this new on-demand session with Physicians Practice, Kem breaks down practical ways to close revenue leakage, prevent denials, and put AI and automation to work in the revenue cycle. |
 💡 Inspiring Future Public Health Leaders
Kem also participated in PHIT4DC’s 2026 PHIT Week Workshop, helping introduce DMV-area high school students and recent graduates to public health informatics, technology, and emerging career opportunities. |
From strengthening today’s practices to inspiring tomorrow’s healthcare workforce, MRCS is proud to help move the industry forward through practical education and shared expertise. |
🎤 MRCS Takes the Stage This Fall |
MRCS is proud to participate in educational programs and industry events that bring healthcare professionals together to learn, connect, and exchange practical ideas. We hope to connect with you at one of these upcoming engagements. |
 
🏥 MGMA Leaders Annual Conference September 27–30, 2026 | San Antonio, TX
Kem will co-present an interactive workshop on building strategic revenue cycle work plans for stronger payer engagement. She will also help facilitate the Black Healthcare Leaders Resource Group Networking Session, creating space for connection, mentorship, and professional growth. |
🎉 Let's have fun! Guess ALL 3 & Win a Coffee! |
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The "Boot Match" Game 🤠 Heading to San Antonio for Medical Group Management Association's 2026 Annual Conference? We’re bringing our boots and our best strategies! Before Doral Jacobsen, MBA FACMPE, Shawntea Gordon, and Kem Tolliver, BS, FACMPE, CPC, CMOM take the stage to discuss Strategic Revenue Cycle Workplan Design for High-Impact Payer Engagement, we have a very important, highly technical question for you: Which boots belong to which speaker? 👢👇 📸 The Lineup:🥾 Boot A: Playful / Sparkley + Bold = giddy up 👢 Boot B: Comfy / Snuggly + Unpretentious = happy feet 🥾 Boot C: Sophisticated / Polished + Sassy = in charge Drop your guesses (A, B, C) in the LinkedIn comments! Bonus - If you guess all three correctly, we'll buy you a coffee at the conference center! |
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🩺 National Organization of Rheumatology Management (NORM) Conference October 1–3, 2026 | New Orleans, LA
At NORM, Kem will present two sessions designed to help rheumatology administrators and new managers strengthen revenue cycle planning, processes, and performance. |
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⭐ UFinity Conference 2026 November 1-3, 2026 | Nashville, TN
At Ufinity, Kem will deliver a keynote presentation focused on revenue cycle leadership, operational excellence, technology adoption, and industry innovation. We hope to see you at one of these events and look forward to connecting, sharing practical ideas, and continuing the conversation. |
🤝 We’re Here to Help |
Whether we connect at an upcoming event, on LinkedIn, or directly with your team, MRCS helps healthcare organizations strengthen the people, processes, and technology behind their operations. Our services include revenue cycle and practice management, payer contracting, coding and risk management, healthcare technology optimization, and content and coaching.
Explore MRCS Services, follow MRCS on LinkedIn for industry insights and updates, or email admin@medrevenuecycle.com to continue the conversation |
💭 Closing Thoughts |
September reminds us that awareness has the greatest impact when it leads to thoughtful action. We hope this issue gives you useful information and practical direction as you guide your organization into the final quarter of the year.
As Labor Day approaches, we also want to say thank you to you—and to all the healthcare professionals and teams you work alongside—for the dedication you bring to patients and communities every single day. We hope you enjoy a safe and restful holiday weekend!
🏈 And for the football fans among us, we hope you find a little time to enjoy the start of the season and cheer on your favorite team. Football is back—let the season begin!
With appreciation, The MRCS Team |
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