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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.

Preparing for CLFS Reimbursement Changes: Why...

Laboratory revenue cycle management encompasses every operational process connecting clinical laboratory services to collected Medicare reimbursement – and in August 2026, it has become the most actionable lever available to laboratory executives preparing for a confirmed payment shift. The Consolidated Appropriations Act, 2026, signed February 3, 2026, delayed all PAMA-related Clinical Laboratory Fee Schedule (CLFS) rate reductions through December 31, 2026 – the seventh Congressional intervention since PAMA was enacted [1]. But the reprieve is temporary.

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Laboratory revenue cycle management review of billing accuracy, denials, reimbursement trends, and 2027 CLFS readiness
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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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U.S. Healthcare Practices
September 04, 2025

8 Essential Questions on Provider Enr...

Imagine this medical billing and credentialing scenario: You’ve hired a new physician. Their start date is set. Patients...

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Medical Coding Audit
July 08, 2025

Medical Coding Audits 101: How Physic...

You’re wrapping up a 10-hour shift. One more note to finish, one last patient to call – and then someone from billing wa...

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Medical Billing Error
June 03, 2025

The Top Medical Billing Errors and Ho...

The healthcare revenue cycle is undergoing significant transformation, driven by evolving regulations, shifting payer po...

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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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Revenue Risks Only a Medical Coding Audit
April 21, 2025

The Hidden Revenue Risks Only a Medic...

In the high-stakes world of healthcare finance, where razor-thin margins and rising regulatory scrutiny are the norm, me...

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Market-based logistics efficiency
June 07, 2023

Pediatric Medicine's Struggle with La...

Pediatric medicine supports some of the most vulnerable members of society. This makes shortages in the space even more ...

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