Staying Ahead of Performance Gaps | May 2026 Insights from MRCS

May 27
6 min read

Updated: May 28

As Q2 moves forward, many organizations are beginning to see where operations are holding steady—and where pressure is starting to build.

Increased volume, payer response patterns, and documentation demands tend to surface quickly this time of year, often revealing gaps that weren’t as visible earlier in the quarter.

Across our work, we’re seeing that the most stable organizations stay focused on the fundamentals—clear front-end processes, consistent documentation, and alignment between clinical activity and revenue cycle performance.

With increasing operational demands, supporting team consistency and reducing avoidable rework remains essential.

This month’s update highlights key developments and practical insights to help you stay ahead and maintain consistency as the quarter progresses.

🔔 Immediate Action Items for May

Several upcoming deadlines require attention in the coming weeks:

MBI Lookup Tool Updates due May 7 – Ensure user access aligns with claims activity

HETS Vendor Enrollment due May 11 – Required to maintain eligibility access

ABN Form Transition required by May 12 – Confirm updated form usage and staff readiness

Addressing these items now can help prevent workflow disruption and ensure continued compliance.

👉 For HETS enrollment details, visit: HETS EDI: How to Enroll | CMS

As organizations work through these operational demands and regulatory expectations, leadership becomes a critical differentiator—particularly in how teams adapt, prioritize, and maintain consistency under pressure.

🎓 CMOM® Live Program | Begins May 14

Certified Medical Office Manager (CMOM®) Live Webinar Training

May 14 – June 25, 2026 | Thursdays | 3:00 – 6:00 PM EST

The CMOM® credential, awarded through the nationally recognized Practice Management Institute, represents a standard of excellence in medical practice management and leadership.

With the program beginning this month, this is the final opportunity to join our inaugural live CMOM® training led by Kem Tolliver.

Participants gain practical tools to strengthen operations while building the confidence to lead effectively in today’s healthcare environment.

Professionals are continuing to recognize the importance of strengthening their knowledge and staying aligned with industry trends:

“Attending a recent practice management forum focused on AI integration in healthcare reinforced the direction I’m working toward and the importance of continuing to grow professionally. It confirmed that advancing my knowledge in healthcare practice management is exactly the next step I need to take.”

- Miragenee

👉 Secure your seat before the program begins: Certified Medical Office Manager (CMOM)® Live Webinar Training | MRCS

Register Online

🧠 Featured Insight: From the Desk of Kem Tolliver

In a recent feature published by HealthCare Leaders Association (HCLA), Kem explores the growing gap between policy changes and operational execution.

While much attention is placed on what has changed, the greater challenge lies in how those changes are translated into day-to-day operations.

Organizations that perform consistently take a proactive approach—aligning clinical operations, documentation, and revenue cycle strategy before disruption occurs.

Key considerations:

✓ Align workflows with policy changes early

✓ Evaluate how reimbursement impacts staffing and performance

✓ Ensure documentation supports evolving requirements

🔔 Key CMS & Industry Updates to Watch

Recent regulatory and federal activity continues to signal a broader shift across healthcare—toward measurable outcomes, stronger payment integrity, and more real-time operational processes. Industry reporting also highlights the growing administrative burden tied to Medicare Advantage, reinforcing the importance of accurate documentation and proactive revenue cycle management.

As volumes continue to rise across Q2, several updates require attention:

• Electronic Claims & Documentation Standards – Effective May 19, 2026

CMS continues advancing digital workflows, reinforcing the need for system readiness.

• PAMA Laboratory Reporting Period Now Open (May 1 – July 31)

Applicable laboratories must submit private payer data for the Clinical Laboratory Fee Schedule (CLFS). Practices with in-house or group-billed lab services should review CMS criteria.

• MIPS Value Pathways (MVP) & CAHPS Registration Now Open

Registration for the 2026 performance year is open. CAHPS registration is required by June 30; MVP registration remains open through November 30.

• Medicare Prior Authorization Activity Continues to Expand

Ongoing pilots signal continued expansion, reinforcing the need for strong tracking and documentation workflows.

• RAPID Coverage Pathway for Medical Devices

CMS and the FDA announced a new pathway to accelerate Medicare coverage for breakthrough medical devices, signaling continued movement toward faster access and innovation.

• Site Visit Processing Delays (Novitas)

Temporary delays in site verification processing may impact application timelines.

• Expanding Focus on Prior Authorization & Interoperability

CMS continues advancing more real-time, electronic prior authorization workflows, with increased emphasis on transparency and faster turnaround times.

For additional CMS updates and resources, refer to CMS MLN Connects communications.

📈 Revenue Cycle Trends We’re Seeing in Q2

As Q2 progresses, performance trends are becoming more visible across the revenue cycle, particularly as volumes increase.

Key areas of focus:

✓ Denial trends by payer and service line

✓ Eligibility accuracy and front-end workflow consistency

✓ Prior authorization tracking and alignment

✓ Charge capture accuracy and documentation support

Addressing these areas early helps prevent compounding issues and supports more stable performance throughout the quarter.

🎓 Strengthening Teams Through Practical Training

As operational demands increase throughout Q2, consistent performance depends on how well teams are trained and aligned.

The MRCS Learning Center provides practical, real-world education to strengthen workflows, improve documentation, and support more effective revenue cycle performance.

Through our partnership with the Practice Management Institute, organizations can access certification programs, instructor-led training, and on-demand resources for both new and experienced team members.

Whether reinforcing best practices or addressing knowledge gaps, the Learning Center offers tools to help teams stay consistent and prepared.

👉 Explore the MRCS Learning Center

🎤 Recent Engagement Highlight

MRCS CEO Kem Tolliver continues to lead the Certified Medical Office Manager (CMOM®) cohort in partnership with University of Mary Washington and Mary Washington Healthcare, as the program approaches its final session on May 8.

Delivered through the Practice Management Institute, this cohort has brought together a dedicated group of healthcare professionals focused on strengthening their knowledge across practice management, financial operations, compliance, and leadership.

Throughout the program, participants have remained highly engaged and committed to building a strong operational foundation that supports both team performance and patient care.

We appreciate the opportunity to support continued professional development and partner with organizations that prioritize education and leadership growth within healthcare.

📅 Upcoming Engagements & Opportunities

Register Online

🏥 MGMA Private Practice Conference

May 3–5, 2026 | St. Louis, MO

Kem is onsite this week, co-presenting sessions and engaging with industry leaders on strengthening independent practice performance, including denial management, KPI alignment, and revenue integrity, while also joining a featured panel on revenue cycle insights.

Register Online

💻 Veradigm Customer Summit 2026

May 6, 2026 | Nashville, TN

Kem will be presenting at the upcoming summit, sharing “Future-Proofing Your Revenue Cycle: Strategies to Reduce Denials and Maximize Technology,” with a focus on reducing denials, optimizing workflows, and maximizing existing technology.

Register Online

🩺 CCPA Annual Meeting

May 13, 2026 | Des Plaines, IL

Kem will co-present later this month, “Build Your Annual Revenue Cycle Playbook,” highlighting structured planning and measurable approaches to improving financial performance.

Register Online

💻 MGMA Digital Summit 2026

June 3, 2026 | Virtual

Kem will present “Leading High-Performance Revenue Cycle Teams,” focused on staffing strategies, performance alignment, and building resilient teams.

Join This Session

🎓 Healthcare Leaders Student Organization (HLSO) Webinar | National University

June 10, 2026 | Virtual | 8:30 PM EST

In collaboration with the Practice Management Institute and the Healthcare Leaders Student Organization (HLSO), MRCS will support a complimentary educational session designed to introduce medical office management, revenue cycle fundamentals, and leadership development for students pursuing careers in healthcare.

🏆 Celebrating Team Milestones

Sydney White, Financial Operations Manager 🎉 3 Years

Sydney has played a key role in supporting financial operations and client engagement. Her oversight of invoicing and payroll, along with client-related financial processes, helps ensure consistency and efficiency across our operations.

Her attention to detail, organization, and reliability continue to strengthen internal coordination and support the team’s ability to deliver high-quality service.

Steve Long, Sr. Director of Practice Management Services 🎉 4 Years

Steve has played an important role in supporting practice management initiatives and client engagements. His leadership and experience continue to contribute to the strength of our services and the success of the organizations we support.

We appreciate the dedication both Sydney and Steve bring to MRCS and look forward to their continued contributions in the years ahead.

🤝 Supporting Stronger Operations

As activity increases across Q2, organizations are often managing competing priorities—volume, staffing, and performance expectations—all at once.

MRCS works alongside healthcare teams to help bring structure to that complexity, focusing on workflow clarity, performance visibility, and practical adjustments that reduce rework and support more consistent outcomes.

To learn more about how MRCS supports practice leaders and healthcare teams, contact us at admin@medrevenuecycle.com.

💭 Closing Thoughts

The coming weeks often test how well systems and teams hold up under pressure. Small gaps in workflow, documentation, or communication can quickly impact performance if left unaddressed.

Staying focused on consistency—particularly across front-end processes and revenue cycle alignment—will be key to maintaining stability as volumes continue to rise.

MRCS will continue to share practical insights to help you stay ahead of those challenges and maintain steady performance.

As Memorial Day approaches, we take a moment to honor and remember those who have served and sacrificed. We extend our appreciation to all who have served and wish everyone a safe and meaningful holiday ahead.