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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.

Why Ambulatory Surgical Center Billing Requir...

Ambulatory Surgery Centers (ASCs) are one of the fastest-growing segments of U.S. healthcare. Advances in minimally invasive techniques, improved anesthesia, and increasing patient demand for lower-cost care continue shifting complex surgical services out of hospitals and into outpatient surgery settings.

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ambulatory surgical center billing ASC medical billing ASC medical coding 2026
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ACO risk adjustment MSSP 2027 CMS proposed rule benchmark ACO REACH risk adjustment solutions revenue cycle
August 01, 2026

What CMS's July 14 Proposed Rule Mean...

CMS's proposed rule arrives against a backdrop of sustained program success....

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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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HCC risk adjustment coding Medicare Advantage
July 07, 2026

Why HCC Risk Adjustment Coding Is a B...

Two things converged in 2026 that make HCC risk adjustment coding a more consequential financial function than it has ev...

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physician coding mistakes payer denials medical billing 2026
June 19, 2026

Top 7 Physician Coding Mistakes Trigg...

Why is physician coding creating more revenue risk in 2026? Physician coding is no longer just a compliance function sit...

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HCC risk adjustment coding defensible Medicare Advantage RADV
June 12, 2026

The New Era of HCC Risk Adjustment: W...

For years, many Medicare Advantage organizations treated HCC risk adjustment as a volume exercise: capture more diagnose...

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OIG Medicare Advantage HCC risk adjustment coding audit 2026
June 07, 2026

OIG Flags $462 Million in Medicare Ad...

On June 1, 2026, the HHS Office of Inspector General published one of the most significant Medicare HCC risk adjustment ...

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medical billing audit services
June 05, 2026

Revenue Integrity in Healthcare: The ...

Revenue is disappearing long before denials ever hit a ledger. Hospitals and health systems still rely heavily on retros...

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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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Accounts Receivable
February 19, 2026

Why 2026 Is the Year Practices Must R...

For U.S. healthcare providers, 2026 represents a genuine inflection point for accounts receivable (AR) – driven by sever...

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