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Insights That Move Healthcare

Expert perspectives on revenue cycle, risk adjustment, compliance, and healthcare strategy – designed to help providers, plans, and leaders make smarter operational and financial decisions.

Why HCC Risk Adjustment Coding Is a Board-Lev...

Two things converged in 2026 that make HCC risk adjustment coding a more consequential financial function than it has ever been for Medicare Advantage organizations.

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HCC risk adjustment coding Medicare Advantage
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accounts receivable management services healthcare outsourcing AR revenue
July 03, 2026

What to Look for in Accounts Receivab...

The U.S. medical billing outsourcing market – which encompasses accounts receivable management services, coding, claims ...

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CMS TEAM model orthopedic billing services 2026
July 01, 2026

What TEAM Means for Orthopedic Billin...

The CMS Transforming Episode Accountability Model (TEAM) is in play, and its impact on orthopedic billing services will ...

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gastroenterology billing services ColoSense
June 29, 2026

Gastroenterology Billing Services Upd...

Gastroenterology practices are navigating revenue cycle changes on multiple fronts in 2026. The 2026 Physician Fee Sched...

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prospective concurrent retrospective risk adjustment 2026 guide MA plans ACOs
June 22, 2026

Prospective, Concurrent, and Retrospe...

Risk adjustment is often discussed as a Medicare Advantage problem. In actuality, it affects every organization whose re...

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physician coding mistakes payer denials medical billing 2026
June 19, 2026

Top 7 Physician Coding Mistakes Trigg...

Why is physician coding creating more revenue risk in 2026? Physician coding is no longer just a compliance function sit...

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home health billing services audit compliance
June 17, 2026

Why Home Health Billing Services Are ...

On May 13, 2026, the Centers for Medicare and Medicaid Services imposed an unprecedented nationwide six-month moratorium...

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HCC risk adjustment coding defensible Medicare Advantage RADV
June 12, 2026

The New Era of HCC Risk Adjustment: W...

For years, many Medicare Advantage organizations treated HCC risk adjustment as a volume exercise: capture more diagnose...

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outsourcing medical billing healthcare accounts receivable management revenue cycle 2026
June 10, 2026

Outsourcing Medical Billing for Healt...

Most healthcare organizations don't decide to outsource medical billing because of a single crisis. The decision builds ...

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denial prevention vs denial management healthcare revenue cycle
June 08, 2026

Denial Prevention vs. Denial Manageme...

In 2025, U.S. hospitals spent $18 billion overturning claims denials. Not losing those claims. Not writing them off. Ov...

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