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  • Blogs

Why RCM Breaks Down Before the Patient Ever Arrives

When a denial lands on your desk, how often do you stop and ask where it really started? Not where it was found—but where it was created. For most teams, the instinct is to look downstream. Billing. Coding. AR. And sometimes that makes sense. But if you’ve ever tracked down ...Read More
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  • Blogs

Where RCM Workflows Fail (And How AI Helps Fix Them)

Everything feels like it’s just barely holding together. You’re juggling backlogs, denials, and documentation gaps while trying to keep the whole machine moving. You feel the pressure. If one chart’s late or an audit flag pops up, suddenly you’re playing defense on two fronts. It’s enough to make you wonder ...Read More
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  • Blogs

The 2026 Documentation Cliff: Why FQHCs, CHCs and Tribal Health Must Master the V28 Risk Adjustment Model Now

For Federally Qualified Health Centers (FQHCs), Community Health Centers (CHCs), and Tribal Health organizations, 2026 marks a transformative—and potentially volatile—inflection point in revenue cycle management. The three-year transition from the CMS-HCC Version 24 (V24) model to Version 28 (V28) has reached its final phase. As of January 1, 2026, 100% of ...Read More
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7 KPIs That Reveal the True Financial Health of an FQHC Revenue Cycle

Federally Qualified Health Centers (FQHCs) operate under a revenue model shaped by mission, regulation, and complexity. Medicaid-dominant payer mixes, encounter-based reimbursement, sliding-fee discounts, and ongoing federal oversight all contribute to an environment in which traditional “collections totals” fail to tell the full financial story. A period with strong receipts can ...Read More
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