All Posts

Coding and compliance aren't back-office tasks, they're critical to protecting revenue. With OIG and CMS targeting medical necessity, telehealth, and modifier misuse, proactive audits are essential. Auditing not only reduces risk but strengthens processes, safeguards cash flow, and ensures long-term RCM resilience.

Insurance verification isn't just paperwork, it's your first line of defense against denials and lost revenue. When done right, it reduces rework, speeds up payments, and improves patient satisfaction. When missed, it leads to delays, write-offs, and billing frustration. Get it right up front, and your entire revenue cycle performs better.

The RCM industry is growing fast, and so is the demand for skilled, adaptable talent. As roles evolve and automation accelerates, scaling your RCM team isn't just about hiring more people; it's about building the right capabilities. This blog explores how today's job market is reshaping the way we grow and structure high-performing RCM teams.

Is your RCM team truly a team, or just a group of people working side by side? High-performing teams are built on trust, shared goals, clear roles, and real accountability. When you hire the right people and let them do their jobs, you create a culture that drives results. If your team were surveyed today, would they say they're part of a high-performing RCM team?

Predictable cash flow starts with predictable data. When patient info, coverage, charges, and documentation flow consistently, your revenue becomes reliable, and your decisions, faster. At Claims Theory, we help healthcare organizations clean up the noise so they can finally trust what their numbers are telling them. Because good data doesn't just report the past, it helps you lead the future.

Data isn't just a report, it's your roadmap. In RCM, smart decision-making starts with understanding your data, not just observing it. Clean claim rates, denial trends, and AR performance all tell a story. The key is turning those insights into action. At Claims Theory, we help organizations move from reactive to strategic by using data to drive decisions, and drive the business forward. Don't guess. Lead with data.

Want to know where your revenue cycle is leaking? Start with AR. The right team will uncover payer delays, process gaps, and hidden financial risks fast. But underinvest, and you'll feel it everywhere: denials, aging, and lost revenue. AR isn't just follow- up, it's financial strategy.

The best investment you can make in RCM is your team. When priorities are clear and people feel supported, everything improves; communication, accountability, outcomes, and client experience. Great teams do more than just work together; they deliver results that build trust and lasting partnerships.

Strong revenue cycle performance doesn't happen by chance. It requires investment in the people, processes, and technology that protect every dollar your organization earns. When RCM is overlooked, denials rise, cash slows, and financial risk increases. At Claims Theory, we help healthcare organizations turn RCM into a strategic asset, because you can't afford to neglect the engine behind your revenue.

Charging with confidence in healthcare means every service gets billed; accurately, completely, and without delay.

When was the last time you reviewed your payer contracts? Take control of your reimbursement with contract clarity.

Building the ultimate RCM machine that is powered by people, fueled by tech and grounded in process is the only way to stay in the game.

Struggling to fill key roles in revenue cycle management? Finding and keeping top RCM talent can feel impossible without the right strategy.

In today’s evolving healthcare landscape, revenue cycle management (RCM) success isn’t just about having the right technology or the...

Innovation is essential for growth, efficiency, and staying competitive in revenue cycle management (RCM), but it doesn’t have to mean...

The revenue cycle management (RCM) industry has been shaped by decades of expertise, dedication, and innovation by some of the most...

In both sports and business, success isn’t about controlling everything—it’s about mastering what you can control. A philosophy deeply...

Underpaid claims can quietly drain revenue from healthcare organizations if not identified and addressed promptly. While denials often...

“ The future doesn’t just happen—it’s built. ” — Jensen Huang In the rapidly evolving world of healthcare technology, staying competitive...

The 10,000-hour rule, popularized by Malcolm Gladwell in Outliers , suggests that mastering a skill requires 10,000 hours of deliberate...