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.

On May 13, 2026, the Centers for Medicare and Medicaid Services imposed an unprecedented nationwide six-month moratorium...
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Most healthcare organizations don't decide to outsource medical billing because of a single crisis. The decision builds ...
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In 2025, U.S. hospitals spent $18 billion overturning claims denials. Not losing those claims. Not writing them off. Ov...
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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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Revenue is disappearing long before denials ever hit a ledger. Hospitals and health systems still rely heavily on retros...
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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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Remote Patient Monitoring (RPM) billing sounds like one of those healthcare ideas that should be simple: Patients stay h...
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Account receivable services don’t often feature prominently in legal proceedings, but a recent case from Ardent Health b...
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The home health revenue cycle has officially entered its “Prove It” era. For years, many home health agencies approache...
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