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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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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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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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Medical Billing Agency
May 20, 2025

How to Choose the Best Medical Billin...

Let’s face it: medical billing isn’t exactly the most glamorous part of running a healthcare practice. But it is the par...

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Enhancing Compliance & Reducing Risk
May 09, 2025

Introduction to the CERT Program: Enh...

For revenue cycle leaders, maintaining compliance while minimizing financial risk is an ongoing challenge. As healthcare...

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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
May 18, 2021

Orthopedic Reimbursement Has Fallen. ...

Orthopedic trauma surgery reimbursements have been dropping. According to a study in the Journal of Orthopaedic Trauma, ...

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Market-based logistics efficiency
April 28, 2021

Physician Billing Fraud and Overpayme...

Overpayments might not top your list of physician billing issues, but with recent CMS actions, it might be time to rethi...

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