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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.

Prospective, Concurrent, and Retrospective Ri...

Risk adjustment is often discussed as a Medicare Advantage problem. In actuality, it affects every organization whose reimbursement, shared savings, or quality performance depends on accurately reflecting the complexity of their patient population.

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prospective concurrent retrospective risk adjustment 2026 guide MA plans ACOs
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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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underpayment revenue leakage medical billing
June 06, 2026

"Paid" Isn't the Same as "Paid Correc...

When a claim comes back paid, the workflow closes. The case moves out of the queue. Someone marks it resolved. The prob...

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Predictive AR Management for Healthcare Providers | 2026
May 27, 2026

Predictive Accounts Receivable Manage...

Here's a question your AR team probably isn't asking: which unpaid claim is most likely to block your cash flow this wee...

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consistent denial management processes
May 18, 2026

Accounts Receivable Adjustment Tagged...

Account receivable services don’t often feature prominently in legal proceedings, but a recent case from Ardent Health b...

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Home Health Billing Service
May 14, 2026

How Home Health Billing Denial Preven...

The home health revenue cycle has officially entered its “Prove It” era. For years, many home health agencies approache...

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Leveraging analytics
May 07, 2026

Which Tools Will CMS Use to Combat La...

The conversation around fraud in laboratory billing, especially in genetic and molecular diagnostics, is no longer theor...

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laboratory revenue cycle management
May 01, 2026

Growing Policy Limitations on IHC Sta...

In today’s US healthcare market, laboratory revenue cycle management (lab RCM) is no longer just about clean billing – i...

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Healthcare Revenue Cycle Management
March 04, 2026

Claim Submission Best Practices for 2...

In 2026’s complex reimbursement landscape, clean claims are the foundation of sustainable revenue and optimized cash flo...

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healthcare revenue cycle
February 16, 2026

The 2026–2027 API Era of Revenue Cycl...

Healthcare’s digital transformation has reached a regulatory inflection point. As of January 2026, the Centers for Medic...

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