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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.

Most Healthcare Audit Exposure Doesn't Start ...

Most of what gets called a coding problem is not a coding problem. It is a documentation problem that surfaces in the coding function – months after the clinical encounter, long after the physician has moved on, usually right before an audit.

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documentation to code integrity medical coding services audit exposure 2026 CMS improper payments U.S. healthcare providers specialty
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physician billing services 2026 Medicare physician fee schedule conversion
July 22, 2026

The 2026 Medicare Physician Fee Sched...

CMS finalized the 2026 Medicare Physician Fee Schedule (MPFS) in October 2025, with policies effective January 1, 2026. ...

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medical coding audit
May 22, 2026

Why Your 99214 Keeps Becoming a 99213...

You’re leaving $25-$40 per visit on the table every time a legitimate 99214 gets downcoded to 99213. Not because someone...

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Market-based logistics efficiency
October 29, 2025

Can Urine Toxicology Lab Services Be ...

With telehealth now a mainstream mode of care, many pathology labs, clinical laboratories, and behavioral health provide...

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medical billing best practices
September 19, 2025

7 Best Practices for Medical Billing ...

If you’re a U.S. healthcare provider searching for medical billing and coding services, you’re not alone. Thousands of p...

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Pediatric Billing
June 20, 2025

AAP Releases 2025 Pediatric Billing G...

A healthy patient financial experience is critical for pediatric providers. Errors in pediatric billing, coding or docum...

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Outsourced Medical Billing in 2025
May 23, 2025

Outsourced Medical Billing in 2025: A...

The medical billing outsourcing market is experiencing unprecedented growth, with the global market size projected to re...

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About Medicaid Managed Care
September 17, 2024

7 Things to Know About Medicaid Manag...

At more than 90 million people, Medicaid sits near the top of the list of the United States’ largest insurers. It covers...

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Market-based logistics efficiency
October 23, 2023

The Helping Kids Cope Act Means a Fre...

Finding new opportunities for pediatric billing is critical to maintaining the health of pediatric medical practices, an...

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Market-based logistics efficiency
September 12, 2023

Changed Your Service Lines? It's Time...

In the wake of COVID, budget crunches, and labor shortages, many hospitals and health systems have been making the smart...

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