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 Accurate HCC Risk Adjustment Can Boost Healthcare Reimbursements in 2025
As the healthcare industry continues to shift toward value-based care, precise Hierarchical Condition Category (HCC) risk adjustment is more important than ever for organizations aiming to optimize reimbursements. The 2025 CMS risk model updates will demand enhanced precision, adaptability, and compliance. To thrive, healthcare organizations must prioritize accuracy
Introduction to the CERT Program: Enhancing Compliance and Reducing Risk
For revenue cycle leaders, maintaining compliance while minimizing financial risk is an ongoing challenge. As healthcare entities continue to see increasing risk from changes to government policies, shifting patient demographics, and shrinking margins, risk management will become an increasingly essential focus for survival. One of the most effective tools for achieving risk management goals is examining the application of Comprehensive Error Rate Testing (CERT) and how it impacts organizations that deal
April 2025 Newsletter
We’ve assembled the latest news for healthcare revenue cycle leaders to help you stay on top of industry challenges and adapt your revenue cycle
The Hidden Revenue Risks Only a Medical Coding Audit Can Reveal
In the high-stakes world of healthcare finance, where razor-thin margins and rising regulatory scrutiny are the norm, medical coding audits have become essential for maintaining revenue integrity, ensuring medical coding compliance, and supporting long-term sustainability. While many providers focus on coding compliance at a surface level,