The Centers for Medicare & Medicaid Services’ (CMS) CY 2026 Rate Announcement introduces significant updates that directly impact medical coding risk adjustment, revenue cycle operations, and overall reimbursement strategy. As healthcare leaders evaluate their prospective risk adjustment strategies in light of these changes, understanding the
The Top Medical Billing Errors and How to Address Them in a Time of Deregulation
The healthcare revenue cycle is undergoing significant transformation, driven by evolving regulations, shifting payer policies, and increasing administrative burdens. For revenue cycle leaders, these changes present both challenges and opportunities, especially in optimizing medical billing accuracy and choosing a medical billing outsourcing company partner.
With the current administration promising more deregulation in
Medical Coding Audits: The Silent Guardian Against $36 Billion in Annual Compliance Risks
Imagine this: A routine payer audit uncovers $250,000 in penalties – all due to overlooked coding errors and cloned notes. For many U.S. healthcare providers, this scenario is all too real. But with a proactive medical coding audit strategy, it doesn’t have to be. This blog explores how a strategic triad of coding audits, clinical documentation reviews, and
Outsourced Medical Billing in 2025: A Complete Guide for U.S. Healthcare Providers
The medical billing outsourcing market is experiencing unprecedented growth, with the global market size projected to reach $54.17 billion by 2034, growing at a compound annual growth rate (CAGR) of 12% from 2025 to 2034 [1]. For healthcare providers, the decision to outsource medical billing is no longer just about cost reduction – it’s a strategic move that drives higher revenue, ensures compliance, and improves operational efficiency. This guide explores the benefits, trends, and implementation
How to Choose the Best Medical Billing Agency (Without Losing Your Sanity)
Let’s face it: medical billing isn’t exactly the most glamorous part of running a healthcare practice. But it is the part that keeps the lights on, pays your staff, and lets you focus on patients instead of paperwork. If you’ve ever found yourself staring at a stack of denied claims, wondering if your EHR system is plotting against you, you’re not alone.
The good news? Outsourcing to the right medical billing agency