Every PM and EHR platform eventually faces the build vs buy decision on payer connectivity. Here is a framework for evaluating both paths, including the hidden costs vendors rarely price in.
August 4, 2026
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Every PM and EHR platform eventually faces the build vs buy decision on payer connectivity. Here is a framework for evaluating both paths, including the hidden costs vendors rarely price in.
CMS rolled back some payer transparency requirements in 2025. With less public payer data available, the institutional knowledge your clearinghouse holds got more valuable, not less.
The CMS Claims Attachments Final Rule took effect May 26, 2026. Compliance is due in 2028. If you are still faxing documentation, here is what 18 months actually looks like.
Clearinghouse problems rarely announce themselves. They quietly show up as denial rate creep, slower payments, and increased staff time. Here are the three signs to watch for.
Enterprise clearinghouses solve enterprise problems. Mid-market practices need a different fit. Here is how to evaluate whether your current vendor matches your operation.
Change Healthcare and TriZetto proved single-rail clearinghouse strategy is a single point of failure. Here is the business case for a second rail, and what it actually protects.
It has been two years since the Change Healthcare cyberattack. Lawsuits are still being filed. Here is what the industry actually learned about single-rail clearinghouse strategy.
Claims Correct from Harris Secure Connect catches the errors that cause denials before claims leave your building. Here is what it does and how early clients are seeing up to 50% denial reductions.
67% of practices believe AI will reduce denials. Only 14% have adopted it. The gap between belief and action is mostly about trust. Here is how to close it responsibly.
In recent years, roughly 80% of breached patient records came from third-party vendors, not from hospital systems. Here is what that pattern means for how you evaluate vendor risk.