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The Revenue Cycle Year in Review: Insights from 2025 and What’s Next for 2026

2025 was a pivotal year for technology. Hospitals and health systems stopped talking about digital transformation and started living it. But change rarely comes easy. Margins tightened. Labor pools shrank. And somewhere in the middle of it all, revenue cycle leaders were expected to keep the lights on while simultaneously ...Read More

Blogs

The AI-Driven Compliance Crucible: Navigating the Next Decade of Medical Billing and RCM Transformation

Healthcare revenue cycle—the people, the processes, and the technology—are currently undergoing a revolution. It presents a dual challenge: the rapid adoption of Artificial Intelligence (AI) and automation to optimize cash flow, in contrast to the increasing prevalence of patient-centric laws, such as the No Surprises Act (NSA). For Chief Financial ...Read More

Blogs

Why Claim Denials Hit Tribal Health Harder—and How RCM Teams Can Reverse the Trend

Claim denials continue to rise across the healthcare landscape, and Tribal Health Organizations (THOs) remain among the most affected. Revenue cycle leaders across Tribal Health Centers, health departments, and Purchased/Referred Care (PRC) programs face payer complexity, stricter documentation requirements, and administrative pressures that far exceed those of most non-Tribal organizations. ...Read More

Blogs

Why Claim Denials Hit Tribal Health Harder—and How RCM Teams Can Reverse the Trend

Blogs

The AI-Driven Compliance Crucible: Navigating the Next Decade of Medical Billing and RCM Transformation

Blogs

How HCC Coding Companies Help Your RAF Scores Tell the Real Story

Ever stare at your RAF scores and think, “These can’t be right?” You know your members are complex. You see the chronic conditions and comorbidities. Yet on paper, the numbers don’t add up…and it feels like money, time, and hard work are slipping through the cracks. Chances are you’ve sat ...Read More

Blogs

5 Denial Management Tactics That Save Millions from the Write-Off Pile

Denials are deflating. Every time one hits your desk, it’s enough to ruin your day. More rework. More delays. And another dent in margins that already feel razor-thin. You’ve probably had a claim you thought was airtight come back rejected. You shake your head…knowing your team will burn hours unraveling ...Read More

Blogs

Retrospective Risk Adjustment: The Shortcut to Capturing Every Dollar You’ve Earned

Margins are razor thin in 2025. And yet, millions still slip away quietly. The endless cycle of missed HCCs, incomplete charts, documentation gaps, and other missteps adds up fast. It feels like trying to fill a bucket with holes. No matter how much effort your team pours in, the revenue ...Read More

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