Preparing for Q3 Operations | June Insights from MRCS

3 days ago
6 min read

As organizations work through the close of Q2, many continue navigating evolving operational expectations across the healthcare landscape. Recent industry activity has placed increased focus on prior authorization workflows, enrollment accuracy, documentation requirements, and overall revenue cycle accountability.

Across our work with healthcare organizations, we continue to see that strong communication, workflow consistency, and proactive oversight remain critical to reducing avoidable delays and maintaining financial performance.

This month’s update highlights important industry developments, compliance reminders, educational opportunities, and practical insights to help organizations stay informed and prepared for the months ahead.

🔔 Immediate Action Items for June

Several operational updates and compliance reminders may require additional attention in the coming weeks:

Prior Authorization & Workflow Readiness

CMS continues advancing electronic prior authorization and interoperability initiatives, reinforcing the importance of stronger workflow coordination, documentation tracking, and electronic process readiness across healthcare organizations.

CERT Documentation Preparedness

Organizations should confirm medical records correspondence information is current and ensure internal workflows support timely responses to CERT documentation requests.

👉 CMS CERT Program Resources

Enrollment Accuracy & Claims Oversight

Effective July 6, outpatient claims billed with TOB 13X or 14X may be returned to provider if practice location addresses do not align with Medicare enrollment records. Organizations should review PECOS enrollment information and confirm practice location accuracy to help avoid claim delays and workflow disruptions.

PEPPER Reports Available for Critical Access Hospitals

FY 2025 PEPPER reports are now available through the PEPPER Portal, providing additional insight into billing patterns, coding trends, and areas requiring monitoring or review.

👉 Access the PEPPER Portal & User Guide

Clinical Laboratory Fee Schedule Preliminary Gapfill Rates

CMS released preliminary gapfill rates under the Clinical Laboratory Fee Schedule, with comments accepted through July 13. Organizations impacted by laboratory reimbursement changes may want to review proposed rates and assess potential operational or financial impacts.

Addressing these areas proactively can help support operational consistency, reduce avoidable delays, and strengthen revenue cycle performance heading into Q3.

📈 Revenue Cycle Trends We’re Currently Seeing

As organizations continue managing increasing operational demands, many are placing additional focus on reducing avoidable delays, improving workflow consistency, and strengthening reimbursement oversight across the revenue cycle.

Areas receiving increased attention:

• Prior authorization tracking and documentation coordination

• Eligibility accuracy and front-end workflow consistency

• Denial management by payer and service line • Charge capture accuracy and documentation support

Organizations that address these areas proactively are often better positioned to support stronger financial performance, improve workflow efficiency, and maintain operational stability.

🔍 Key CMS & Industry Updates to Watch

Recent federal activity continues to reflect increased focus on electronic workflows, payment integrity, documentation accountability, and reimbursement oversight across healthcare organizations.

CMS also recently proposed changes impacting Medicaid state-directed payment limits, signaling potential future reimbursement implications for organizations with significant Medicaid patient populations. In addition, the 2024 MIPS Doctors and Clinicians Preview Period remains open through June 11, allowing organizations to review performance information prior to public reporting.

CMS also continues expanding electronic prior authorization and WISeR model initiatives across Medicare workflows, while advancing broader interoperability efforts tied to electronic authorization processes and data exchange requirements. These efforts reinforce the growing emphasis on electronic documentation processes, utilization oversight, and workflow readiness across healthcare organizations.

👉 CMS WISeR Model Overview

Areas organizations should continue monitoring:

• Electronic prior authorization and interoperability initiatives

• Continued expansion of WISeR model activity across Medicare workflows

• Enrollment and provider data accuracy requirements

• Documentation and audit preparedness efforts

• Billing oversight and reimbursement trend monitoring

🎓 Continuing Education & Professional Development

As healthcare operations continue evolving, many organizations are placing increased focus on ongoing education, leadership development, and role-specific training to help teams stay informed and prepared.

Through the MRCS Learning Center and our partnership with the Practice Management Institute, healthcare professionals have access to practical educational resources, certification programs, instructor-led training, and on-demand learning opportunities designed to support both new and experienced professionals.

Whether supporting leadership growth, strengthening operational knowledge, or reinforcing revenue cycle best practices, continued education remains an important part of building stronger healthcare teams.

👉 Explore the MRCS Learning Center

🎤 Recent Speaking & Industry Engagements

MRCS CEO Kem Tolliver recently presented at MGMA’s Private Practice Conference in St. Louis, Missouri, leading discussions focused on revenue integrity, denial management, operational performance, and the growing challenges facing independent healthcare practices.

Session topics included revenue cycle resilience, workflow optimization, KPI management, payer pressures, and practical strategies to reduce revenue leakage while improving operational alignment across healthcare organizations.

Additional Industry Engagements

Kem also recently presented at the Veradigm Conference and the Children’s Community Physicians Association (CCPA) 2026 Annual Meeting, sharing practical insights on workflow optimization, denial prevention strategies, KPI management, and structured revenue cycle planning.

Thank you to organizations like MGMA, Veradigm, and CCPA for continuing to support education, collaboration, and professional development opportunities that strengthen healthcare leadership and operational performance across the industry.

🎓 CMOM® Live Training Now Underway

MRCS CEO Kem Tolliver is currently leading our inaugural Certified Medical Office Manager (CMOM®) Live Webinar Training cohort in partnership with the Practice Management Institute.

The nationally recognized CMOM® program continues to generate strong engagement as healthcare professionals strengthen leadership skills, operational knowledge, compliance awareness, and revenue cycle understanding through practical, real-world learning.

We are proud to support this group of professionals committed to continued education, leadership development, and growth across today’s evolving healthcare environment.

If you were unable to join this live cohort, on-demand CMOM® training opportunities remain available through the MRCS Learning Center. Additional live CMOM® training opportunities may also be offered in the future, so be sure to continue checking our website and upcoming newsletters for future announcements and educational updates.

📅 Upcoming Engagements & Opportunities

💻 Healthcare Leaders Student Organization (HLSO) at National University

June 10, 2026 | Virtual

MRCS CEO Kem Tolliver will present From Practice Manager to CEO: Leadership, Revenue Cycle Strategy, and Career Growth in Healthcare, sharing practical leadership lessons, revenue cycle insights, and career development strategies for healthcare professionals navigating today’s evolving healthcare environment.

The session will also highlight the value of professional credentials such as the CMOM® and include a live Q&A discussion focused on real-world operational and leadership experiences.

Join This Session

🏥 MGMA Leaders Annual Conference

September 27–30, 2026 | San Antonio, TX

Kem Tolliver will co-present Strategic Revenue Cycle Workplan Design for High-Impact Payer Engagement, an interactive workshop focused on strengthening operational efficiency, reducing reimbursement friction, improving denial management strategies, and developing payer-focused revenue cycle workplans that support stronger financial performance and operational predictability.

Register

🩺 National Organization of Rheumatology Management (NORM) Conference

October 1–3, 2026 | New Orleans, LA

Kem Tolliver will present both a general session and breakout session focused on revenue cycle management strategy, operational planning, and foundational revenue cycle approaches for healthcare managers and administrative leaders.

Register

🎙️ Upcoming Amplity Podcast Feature – Cancer Clearly

MRCS CEO Kem Tolliver will soon join Amplity’s Cancer Clearly podcast for an upcoming conversation focused on healthcare leadership, professional development, the value of the CMOM® credential, and current revenue cycle management trends impacting oncology practices.

The discussion will highlight Kem’s professional journey, leadership experience, and continued advocacy for workforce development and education across today’s evolving healthcare landscape.

We are excited for this upcoming collaboration and appreciate the opportunity to contribute to important industry conversations surrounding healthcare leadership, operational excellence, and professional growth.

Stay tuned for future release details and additional updates!

🌿 Celebrating the Next Generation of Healthcare Leadership

MRCS CEO Kem Tolliver recently attended the 2026 Nature and Health Symposium in Seattle, Washington, in support of her daughter, Sasha Tolliver-Chavez, M.S., as she presented during the event.

Congratulations to Sasha on this exciting accomplishment and for contributing to important conversations surrounding health, community, and public health leadership.

This month, we recognize Juneteenth and its historical significance as a commemoration of freedom, resilience, and progress.

At MRCS, we value the importance of leadership, education, community engagement, and continued efforts that support stronger and more inclusive healthcare environments.

🤝 Supporting Stronger Healthcare Operations

Healthcare organizations continue balancing increasing operational expectations, reimbursement pressures, staffing challenges, and evolving compliance requirements across the revenue cycle.

MRCS partners with healthcare leaders and teams to help strengthen operational workflows, improve revenue cycle performance, reduce avoidable rework, and support more consistent day-to-day operations through practical, experience-driven solutions.

To learn more about how MRCS can support you or your organization, contact us at admin@medrevenuecycle.com.

💭 Closing Thoughts

As healthcare organizations continue navigating evolving operational demands, maintaining consistency across workflows, communication, documentation, and revenue cycle processes remain essential to long-term stability and performance.

Small operational gaps can quickly create downstream challenges, making proactive planning, collaboration, and workflow alignment increasingly important across healthcare organizations.

MRCS remains committed to sharing practical insights, education, and operational strategies that support stronger healthcare leadership and more effective revenue cycle performance.

Juneteenth also serves as an important reminder of the value of continued progress, education, opportunity, and community within healthcare and beyond. We thank all our clients, partners, colleagues, and healthcare professionals for the important work you continue to do every day.