CareCloud (CCLD) 10-Q 8 Aug 18 2018 Q2 Quarterly report Financial data

Document and Entity Information

Document and Entity Information - shares	6 Months Ended
	Jun. 30, 2018	Aug. 06, 2018
Document And Entity Information
Entity Registrant Name	MEDICAL TRANSCRIPTION BILLING, CORP
Entity Central Index Key	1,582,982
Document Type	10-Q
Document Period End Date	Jun. 30, 2018
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Filer Category	Smaller Reporting Company
Entity Common Stock, Shares Outstanding		11,846,424
Trading Symbol	MTBC
Document Fiscal Period Focus	Q2
Document Fiscal Year Focus	2,018

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($)	Jun. 30, 2018	Dec. 31, 2017
CURRENT ASSETS:
Cash	$ 11,722,619	$ 4,362,232
Accounts receivable - net of allowance for doubtful accounts of $192,000 and $185,000 at June 30, 2018 and December 31, 2017, respectively	3,437,850	3,879,463
Contract asset	1,669,323
Current assets - related party	25,203	25,203
Prepaid expenses and other current assets	1,730,621	662,822
Total current assets	18,585,616	8,929,720
Property and equipment - net	1,388,173	1,385,743
Intangible assets - net	1,702,240	2,509,544
Goodwill	12,263,943	12,263,943
Other assets	424,725	436,713
TOTAL ASSETS	34,364,697	25,525,663
CURRENT LIABILITIES:
Accounts payable	590,266	991,859
Accrued compensation	1,033,945	1,137,351
Accrued expenses	922,244	616,778
Deferred rent (current portion)	88,697	81,826
Deferred revenue (current portion)	27,675	62,104
Accrued liability to related party	10,663	10,675
Notes payable - other (current portion)	81,295	168,718
Contingent consideration (current portion)	563,466	505,557
Dividend payable	1,056,217	747,147
Total current liabilities	4,374,468	4,322,015
Notes payable - other	140,613	120,899
Deferred rent	255,468	333,788
Deferred revenue	28,212	28,615
Contingent consideration		97,854
Deferred tax liability	450,072	372,072
Total liabilities	5,248,833	5,275,243
SHAREHOLDERS' EQUITY:
Preferred stock, par value $0.001 per share - authorized 2,000,000 shares; issued and outstanding 1,536,289 and 1,086,739 shares at June 30, 2018 and December 31, 2017, respectively	1,536	1,087
Common stock, $0.001 par value - authorized 19,000,000 shares; issued 12,405,973 and 12,271,390 shares at June 30, 2018 and December 31, 2017, respectively; outstanding, 11,665,174 and 11,530,591 shares at June 30, 2018 and December 31, 2017, respectively	12,406	12,272
Additional paid-in capital	52,710,345	45,129,517
Accumulated deficit	(21,794,949)	(23,509,386)
Accumulated other comprehensive loss	(1,151,474)	(721,070)
Less: 740,799 common shares held in treasury, at cost at June 30, 2018 and December 31, 2017	(662,000)	(662,000)
Total shareholders' equity	29,115,864	20,250,420
TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY	$ 34,364,697	$ 25,525,663

Condensed Consolidated Balance3

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($)	Jun. 30, 2018	Dec. 31, 2017
Statement of Financial Position [Abstract]
Allowance for doubtful accounts receivable	$ 192,000	$ 185,000
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	2,000,000	2,000,000
Preferred stock, shares issued	1,536,289	1,086,739
Preferred stock, shares outstanding	1,536,289	1,086,739
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	19,000,000	19,000,000
Common stock, shares, issued	12,405,973	12,271,390
Common stock, shares, outstanding	11,665,174	11,530,591
Treasury stock, shares	740,799	740,799

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($)	3 Months Ended			6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017
Income Statement [Abstract]
NET REVENUE	$ 8,682,937	$ 7,784,750		$ 16,990,262	$ 16,004,824
OPERATING EXPENSES:
Direct operating costs	4,333,573	4,197,824		8,817,628	9,420,560
Selling and marketing	403,057	268,958		708,071	624,469
General and administrative	3,054,205	2,771,811		5,654,939	5,758,474
Research and development	248,921	313,400		504,800	594,249
Change in contingent consideration	11,030	162,611		42,780	151,423
Depreciation and amortization	559,696	1,453,145		1,150,467	2,972,690
Restructuring charges			$ 276,000		275,628
Total operating expenses	8,610,482	9,167,749		16,878,685	19,797,493
OPERATING INCOME (LOSS)	72,455	(1,382,999)		111,577	(3,792,669)
OTHER:
Interest income	29,939	4,731		35,224	8,152
Interest expense	(74,167)	(285,144)		(148,248)	(564,569)
Other income - net	218,589	36,839		369,963	74,870
INCOME (LOSS) BEFORE INCOME TAXES	246,816	(1,626,573)		368,516	(4,274,216)
Income tax provision	51,536	67,030		98,200	127,332
NET INCOME (LOSS)	195,280	(1,693,603)		270,316	(4,401,548)
Preferred stock dividend	1,248,717	427,875		2,024,049	630,454
NET LOSS ATTRIBUTABLE TO COMMON SHAREHOLDERS	$ (1,053,437)	$ (2,121,478)		$ (1,753,733)	$ (5,032,002)
Loss per common share:
Basic and diluted loss per share	$ (0.09)	$ (0.20)		$ (0.15)	$ (0.48)
Weighted-average basic and diluted shares outstanding	11,665,174	10,833,075		11,641,190	10,504,417

Condensed Consolidated Stateme5

Condensed Consolidated Statements of Comprehensive Loss (Unaudited) - USD ($)		3 Months Ended		6 Months Ended
		Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Statement of Comprehensive Income [Abstract]
NET INCOME (LOSS)		$ 195,280	$ (1,693,603)	$ 270,316	$ (4,401,548)
OTHER COMPREHENSIVE LOSS, NET OF TAX
Foreign currency translation adjustment	[1]	(227,258)	11,811	(430,404)	(30,851)
COMPREHENSIVE LOSS		$ (31,978)	$ (1,681,792)	$ (160,088)	$ (4,432,399)
[1]	No tax effect has been recorded as the Company recorded a valuation allowance against the tax benefit from its foreign currency translation adjustments.

Condensed Consolidated Stateme6

Condensed Consolidated Statement of Shareholders' Equity (Unaudited) - USD ($)	Preferred Stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Accumulated Deficit [Member]	Accumulated Other Comprehensive Loss [Member]	Treasury (Common) Stock [Member]	Total
Balance at Dec. 29, 2017	$ 1,087	$ 12,272	$ 45,129,517	$ (23,509,386)	$ (721,070)	$ (662,000)	$ 20,250,420
Balance, shares at Dec. 29, 2017	1,086,739	12,271,390
Cumulative effect of adopting ASC 606				1,444,121			1,444,121
Balance at Jan. 02, 2018	$ 1,087	$ 12,272	45,129,517	(22,065,265)	(721,070)	(662,000)	21,694,541
Balance, shares at Jan. 02, 2018	1,086,739	12,271,390
Balance at Dec. 31, 2017	$ 1,087	$ 12,272	45,129,517	(22,065,265)	(721,070)	(662,000)	20,250,420
Balance, shares at Dec. 31, 2017	1,086,739	12,271,390
Net income				270,316			270,316
Foreign currency translation adjustment					(430,404)		(430,404)
Issuance of stock under the Amended and Restated Equity Incentive Plan	$ 29	$ 134	(163)
Issuance of stock under the Amended and Restated Equity Incentive Plan, shares	29,550	134,583
Stock-based compensation, net of cash settlements			476,800				476,800
Tax withholding obligations on stock issued to employees			(226,250)				(226,250)
Issuance of preferred stock, net of fees and expenses	$ 420		9,354,490				9,354,910
Issuance of preferred stock, net of fees and expenses, shares	420,000
Preferred stock dividends			(2,024,049)				(2,024,049)
Balance at Jun. 30, 2018	$ 1,536	$ 12,406	$ 52,710,345	$ (21,794,949)	$ (1,151,474)	$ (662,000)	$ 29,115,864
Balance, shares at Jun. 30, 2018	1,536,289	12,405,973

Condensed Consolidated Stateme7

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($)	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
OPERATING ACTIVITIES:
Net income (loss)	$ 270,316	$ (4,401,548)
Adjustments to reconcile net income (loss) to net cash provided by (used in) operating activities:
Depreciation and amortization	1,150,467	2,972,690
Amortization of sales commissions	26,472
Deferred rent	(36,022)	(22,013)
Deferred revenue	(34,832)	659
Provision for doubtful accounts	112,406	320,616
Provision for deferred income taxes	78,000	110,000
Foreign exchange gain	(332,100)	(2,835)
Interest accretion	95,604	134,870
Non-cash restructuring charges		17,001
Stock-based compensation expense	537,402	208,035
Change in contingent consideration	42,780	151,423
Changes in operating assets and liabilities:
Accounts receivable	329,207	530,913
Other assets	(91,643)	30,449
Accounts payable and other liabilities	(180,452)	(739,145)
Net cash provided by (used in) operating activities	1,967,605	(688,885)
INVESTING ACTIVITIES:
Capital expenditures	(376,430)	(345,215)
Cash deposit paid for acquisition	(1,000,000)
Net cash used in investing activities	(1,376,430)	(345,215)
FINANCING ACTIVITIES:
Proceeds from issuance of common stock, net of placement costs		2,000,000
Proceeds from issuance of preferred stock, net of placement costs	9,415,000	6,536,217
Preferred stock dividends paid	(1,714,979)	(410,827)
Settlement of tax withholding obligations on stock issued to employees	(213,675)	(195,912)
Repayments of notes payable	(139,485)	(4,287,506)
Proceeds from line of credit		400,000
Repayments of line of credit		(400,000)
Contingent consideration payments	(82,725)	(33,114)
Other financing activities	(60,090)	(217,448)
Net cash provided by financing activities	7,204,046	3,391,410
EFFECT OF EXCHANGE RATE CHANGES ON CASH	(434,834)	(23,704)
NET INCREASE IN CASH	7,360,387	2,333,606
CASH - Beginning of the period	4,362,232	3,476,880
CASH - End of period	11,722,619	5,810,486
SUPPLEMENTAL NONCASH INVESTING AND FINANCING ACTIVITIES:
Vehicle financing obtained	75,372	30,746
Dividends declared, not paid	1,056,217	422,206
SUPPLEMENTAL INFORMATION - Cash paid during the period for:
Income taxes	29,673	7,263
Interest	$ 20,221	$ 254,414

Organization and Business

Organization and Business	6 Months Ended
	Jun. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Business	1. Organization and Business Medical Transcription Billing, Corp. (and together with its subsidiaries “MTBC” or the “Company”) is a healthcare information technology company that offers an integrated suite of proprietary cloud-based electronic health records and practice management solutions, together with related business services, to healthcare providers. The Company’s integrated services are designed to help customers increase revenues, streamline workflows and make better business and clinical decisions, while reducing administrative burdens and operating costs. The Company’s services include full-scale revenue cycle management, electronic health records, and other technology-driven practice management services for private and hospital-employed healthcare providers. MTBC has its corporate offices in Somerset, New Jersey and maintains account management teams in various US offices and operates facilities in Pakistan and Sri Lanka. MTBC was founded in 1999 and incorporated under the laws of the State of Delaware in 2001. In 2004, MTBC formed MTBC Private Limited (or “MTBC Pvt. Ltd.”) a 99.9% majority-owned subsidiary of MTBC based in Pakistan. The remaining 0.01% of the shares of MTBC Pvt. Ltd. is owned by the founder and Executive Chairman of MTBC. In 2016, MTBC formed MTBC Acquisition Corp. (“MAC”), a Delaware corporation, in connection with its acquisition of substantially all the assets of MediGain, LLC and its subsidiary, Millennium Practice Management Associates, LLC (together “MediGain”). MAC has a wholly-owned subsidiary in Sri Lanka, RCM MediGain Colombo, Pvt. Ltd. In conjunction with its continued growth of its offshore operations in Pakistan and Sri Lanka, in April 2017, MTBC began the winding down of its operations in India and Poland. These operations have been terminated and the Indian subsidiary is being liquidated. The Poland subsidiary has been liquidated. In May 2018, MTBC formed MTBC Health, Inc. (“MHI”) and MTBC Practice Management, Corp., (“MPM”) each a Delaware corporation, in connection with its acquisition of substantially all of the revenue cycle, practice management, and group purchasing organization assets of Orion Healthcorp, Inc. and 13 of its affiliates (together, “Orion”). (See Note 15.) MHI is a direct, wholly owned subsidiary of MTBC, and was formed to own and operate the revenue cycle management and group purchasing organization businesses acquired from Orion. MPM is a wholly owned subsidiary of MHI, and was formed to own and operate the practice management business acquired from Orion.

Basis of Presentation

Basis of Presentation	6 Months Ended
	Jun. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	2. BASIS OF PRESENTATION The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial reporting and as required by Regulation S-X, Rule 8-03. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of the Company’s management, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting of items of a normal and recurring nature) necessary to present fairly the Company’s financial position as of June 30, 2018, the results of operations for the three and six months ended June 30, 2018 and 2017 and cash flows for the six months ended June 30, 2018 and 2017. When preparing financial statements in conformity with GAAP, the Company must make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ significantly from those estimates. The condensed consolidated balance sheet as of December 31, 2017 was derived from our audited consolidated financial statements. The accompanying unaudited condensed consolidated financial statements and notes thereto should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2017, which are included in the Company’s Annual Report on Form 10-K, filed with the SEC on March 7, 2018. Recent Accounting Pronouncements The Company adopted Accounting Standards Update (“ASU”) 2014-09, Revenue from Contracts with Customers The Company determined that the only significant incremental cost incurred to obtain contracts within the scope of ASC 606, are sales commissions paid to sales people and outside referral sources. Under the new standard, certain costs to obtain a contract, which we previously expensed, are deferred and amortized over the period of contract performance or a longer period, generally the expected client life. The impact to the accumulated deficit as of January 1, 2018 was approximately $101,000. As of June 30, 2018, the capitalized sales commissions were approximately $113,000. Amortization of capitalized sales commissions for the three and six months ended June 30, 2018 was approximately $14,000 and $26,000, respectively. The following table reconciles the balances as presented for the three and six months ended June 30, 2018 to the balances prior to the adjustments made to implement the new revenue recognition standard for the same period: Three Months Ended June 30, 2018 Six Months Ended June 30, 2018 As Presented Impact of New Revenue Standard Previous Revenue Standard As Presented Impact of New Revenue Standard Previous Revenue Standard NET REVENUE $ 8,682,937 $ 279,560 $ 8,403,377 $ 16,990,262 $ 326,631 $ 16,663,631 OPERATING EXPENSES: Direct operating costs 4,333,573 - 4,333,573 8,817,628 - 8,817,628 Selling and marketing 403,057 (7,688 ) 410,745 708,071 (11,225 ) 719,296 General and administrative 3,054,205 - 3,054,205 5,654,939 - 5,654,939 Research and development 248,921 - 248,921 504,800 - 504,800 Change in contingent consideration 11,030 - 11,030 42,780 - 42,780 Depreciation and amortization 559,696 - 559,696 1,150,467 - 1,150,467 Total operating expenses 8,610,482 (7,688 ) 8,618,170 16,878,685 (11,225 ) 16,889,910 OPERATING INCOME (LOSS) 72,455 287,248 (214,793 ) 111,577 337,856 (226,279 ) OTHER: Interest income 29,939 - 29,939 35,224 - 35,224 Interest expense (74,167 ) - (74,167 ) (148,248 ) - (148,248 ) Other income - net 218,589 - 218,589 369,963 - 369,963 INCOME BEFORE INCOME TAXES 246,816 287,248 (40,432 ) 368,516 337,856 30,660 Income tax provision 51,536 - 51,536 98,200 - 98,200 NET INCOME (LOSS) $ 195,280 $ 287,248 $ (91,968 ) $ 270,316 $ 337,856 $ (67,540 ) Preferred stock dividend 1,248,717 - 1,248,717 2,024,049 - 2,024,049 NET (LOSS) INCOME ATTRIBUTABLE TO COMMON SHAREHOLDERS $ (1,053,437 ) $ 287,248 $ (1,340,685 ) $ (1,753,733 ) $ 337,856 $ (2,091,589 ) Loss per common share: Basic and diluted (loss) income per share $ (0.09 ) $ 0.02 $ (0.11 ) $ (0.15 ) $ 0.03 $ (0.18 ) These condensed consolidated financial statements include enhanced disclosures, particularly around the contract asset and the disaggregation of revenue. See Note 9, “Revenue,” for these enhanced disclosures. In February 2016, the FASB issued ASU No. 2016-02, Leases We plan to adopt the new standard on a modified retrospective basis. We have assigned internal resources to assist in the evaluation of the potential impacts of this standard. Implementation efforts to date have included training on the new standards, the review of lease agreements and other contracts to evaluate potential embedded leases. The Company is continuing to evaluate the effect that Topic 842 will have on its consolidated financial statements and related disclosures. We are in the process of implementing changes to our processes and controls in conjunction with the review of existing lease agreements in connection with the adoption of the new standard. Implementation efforts to date have included training on the new standard, the review of lease agreements and other contracts and the purchase of software to assist us in the accounting and evaluation required under Topic 842. We anticipate that this standard will have a material impact on our consolidated financial statements, as all long-term leases will be capitalized on the condensed consolidated balance sheet. We expect that our leases designated as operating leases in Note 11 – Commitments and Contingencies included in our Annual Report on Form 10-K for the year ended December 31. 2017, filled with the Securities and Exchange Commission on March 7, 2018 will be reported on the consolidated balance sheet upon adoption. Also in January 2017, the FASB issued ASU No. 2017-04, Intangibles – Goodwill and Other : Simplifying the Accounting for Goodwill Impairment On February 14, 2018, the FASB issued ASU 2018-02, Income Statement-Reporting Comprehensive Income (Topic 220): Reclassification of Certain Tax Effects from Accumulated Other Comprehensive Income.

Acquisition

Acquisition	6 Months Ended
	Jun. 30, 2018
Business Combinations [Abstract]
Acquisition	3. ACQUISITION 2017 Acquisition Effective July 1, 2017, the Company purchased substantially all of the assets of Washington Medical Billing, LLC (“WMB”), a Washington limited liability company. In accordance with the asset purchase agreement, the Company agreed to a non-refundable initial payment (the “Initial Payment Amount”) of $205,000. In addition to the Initial Payment Amount, the Company agreed to pay the sellers a percentage of revenue collected from the WMB accounts for the three years, subsequent to the acquisition date to the extent such amounts in the aggregate exceed the Initial Payment Amount (the “WMB Installment Payments”). Based on the Company’s revenue forecast, it does not appear that there will be any WMB Installment Payments and therefore the aggregate purchase price of WMB was determined to be $205,000. Revenue earned from the WMB acquisition was approximately $47,000 and $113,000 during the three and six months ended June 30, 2018, respectively. Pro forma financial information (Unaudited) The unaudited pro forma information below represents condensed consolidated results of operations as if the WMB acquisition occurred on January 1, 2017. The pro forma information has been included for comparative purposes and is not indicative of results of operations that the Company would have had if the acquisitions occurred on the above date, nor is it necessarily indicative of future results. Pro forma information for the three and six months ended June 30, 2018 is not presented as there was no acquisition which was not fully reflected in the Company’s condensed consolidated financial statements during those periods. Three Months Ended Six Months Ended June 30, 2017 June 30, 2017 Total revenue $ 8,041 $ 16,523 Net loss attributable to common shareholders $ (2,108 ) $ (5,003 ) Net loss per common share $ (0.19 ) $ (0.48 )

Goodwill and Intangible Assets-

Goodwill and Intangible Assets-Net	6 Months Ended
	Jun. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets-Net	4. GOODWILL AND INTANGIBLE ASSETS-NET Goodwill consists of the excess of the purchase price over the fair value of identifiable net assets of businesses acquired. The following is the summary of the changes to the carrying amount of goodwill for the six months ended June 30, 2018 and the year ended December 31, 2017: June 30, 2018 December 31, 2017 Beginning gross balance $ 12,263,943 $ 12,178,868 Acquisition - 85,075 Ending gross balance $ 12,263,943 $ 12,263,943 Intangible assets include customer contracts and relationships and covenants not-to-compete acquired in connection with acquisitions, as well as trademarks acquired and software costs. Intangible assets - net as of June 30, 2018 and December 31, 2017 consist of the following: June 30, 2018 December 31, 2017 Contracts and relationships acquired $ 16,491,300 $ 16,491,300 Non-compete agreements 1,236,377 1,236,377 Other intangible assets 1,521,664 1,498,417 Total intangible assets 19,249,341 19,226,094 Less: Accumulated amortization (17,547,101 ) (16,716,550 ) Intangible assets - net $ 1,702,240 $ 2,509,544 Amortization expense was approximately $854,000 and $2.6 million for the six months ended June 30, 2018 and 2017 and $415,000 and $1.3 million for the three months ended June 30, 2018 and 2017, respectively. The weighted-average amortization period is three years. As of June 30, 2018, future amortization scheduled to be expensed is as follows: Years Ending December 31 2018 (six months) $ 737,104 2019 850,389 2020 103,127 2021 11,620 Total $ 1,702,240

Net Loss Per Common Share

Net Loss Per Common Share	6 Months Ended
	Jun. 30, 2018
Loss per common share:
Net Loss Per Common Share	5. NET LOss per COMMON share The following table presents the basic and diluted net loss per weighted-average shares outstanding for the three and six months ended June 30, 2018 and 2017: Three Months Ended Six Months Ended June 30, June 30, 2018 2017 2018 2017 Basic and Diluted: Net loss attributable to common shareholders $ (1,053,437 ) $ (2,121,478 ) $ (1,753,733 ) $ (5,032,002 ) Weighted average shares applicable to common shareholders used in computing basic and diluted loss per share 11,665,174 10,833,075 11,641,190 10,504,417 Net loss attributable to common shareholders per share - Basic and Diluted $ (0.09 ) $ (0.20 ) $ (0.15 ) $ (0.48 ) All unvested restricted stock units (“RSUs”), the 200,000 warrants granted to Opus Bank (“Opus”), the 2,000,000 warrants issued during the second quarter of 2017 as part of the registered direct sale of common stock (which expired unexercised in May 2018) and the 125,000 warrants granted to Silicon Valley Bank (“SVB”) in October 2017 have been excluded from the above calculations as they were anti-dilutive. Vested RSUs and vested restricted shares have been included in the above calculations.

Debt

Debt	6 Months Ended
	Jun. 30, 2018
Debt Disclosure [Abstract]
Debt	6. DEBT SVB In connection with the SVB debt agreement, the Company paid SVB approximately $50,000 of fees upfront and issued warrants for SVB to purchase 125,000 shares of its common stock, and committed to pay an annual anniversary fee of $50,000 a year. Based on the terms in the SVB credit agreement, the warrants have a strike price equal to $3.92. They have a five-year exercise window and net exercise rights, and were valued at $3.12 per warrant. The SVB credit agreement contains various covenants and conditions governing the revolving line of credit. These covenants include a minimum level of adjusted EBITDA and a minimum liquidity ratio. At June 30, 2018, the Company was in compliance with all covenants. Opus Vehicle Financing Notes Insurance Financing

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2018
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	7. Commitments and Contingencies Legal Proceedings , From time to time, we may become involved in other legal proceedings arising in the ordinary course of our business. Including the proceeding described above, we are not presently a party to any legal proceedings that, in the opinion of our management, would individually or taken together have a material adverse effect on our business, consolidated results of operations, financial position or cash flows of the Company. Leases Future minimum lease payments under non-cancelable operating leases for office space as of June 30, 2018 are as follows: Years Ending December 31 Total 2018 (six months) $ 158,055 2019 198,193 Total $ 356,248 Total rental expense, included in direct operating costs and general and administrative expense in the condensed consolidated statements of operations, amounted to approximately $436,000 and $453,000 for the six months ended June 30, 2018 and 2017, respectively, and $220,000 and $224,000 for the three months ended June 30, 2018 and 2017, respectively. Acquisitions —

Related Parties

Related Parties	6 Months Ended
	Jun. 30, 2018
Related Party Transactions [Abstract]
Related Parties	8. Related PARTIES The Company had sales to a related party, a physician who is the wife of the Executive Chairman. Revenues from this customer were approximately $9,000 and $8,000 for the six months ended June 30, 2018 and 2017, respectively and $4,000 for both the three months ended June 30, 2018 and 2017. As of June 30, 2018 and December 31, 2017, the receivable balance due from this customer was approximately $1,400 and $1,900, respectively. The Company is a party to a nonexclusive aircraft dry lease agreement with Kashmir Air, Inc. (“KAI”), which is owned by the Executive Chairman. The Company recorded an expense of approximately $64,000 for both the six months ended June 30, 2018 and 2017 and $32,000 for both the three months ended June 30, 2018 and 2017. As of June 30, 2018 and December 31, 2017, the Company had a liability outstanding to KAI of approximately $11,000, which is included in accrued liability to related party in the condensed consolidated balance sheets. The Company leases its corporate offices in New Jersey, its temporary housing for its foreign visitors, a storage facility and its backup operations center in Bagh, Pakistan, from the Executive Chairman. The related party rent expense was approximately $95,000 and $94,000 for the six months ended June 30, 2018 and 2017 respectively, and for both the three months ended June 30, 2018 and 2017 was approximately $47,000, and is included in direct operating costs and general and administrative expense in the condensed consolidated statements of operations. Current assets-related party in the condensed consolidated balance sheets includes security deposits related to the leases of the Company’s corporate offices of approximately $13,000 as of both June 30, 2018 and December 31, 2017. The June 30, 2018 and December 31, 2017 balances also include prepaid rent paid to the Executive Chairman of approximately $12,000.

Revenue

Revenue	6 Months Ended
	Jun. 30, 2018
Revenue from Contract with Customer [Abstract]
Revenue	9. REVENUE The Company accounts for revenue in accordance with ASC 606, Revenue from Contracts with Customers All of our revenue is derived from contracts with customers and is reported as revenue in the condensed consolidated statements of operations. In many cases, our clients may terminate their agreements with 90 days’ notice without cause, thereby limiting the term in which we have enforceable rights and obligations, although this time period can vary between clients. Our payment terms are normally net 30 days. We provide value to our clients over the term of the contract and recognize revenue ratably over the term, which is consistent with the measure of progress. In the event that we are entitled to variable consideration for services provided during a specific time period, fees for these services are allocated to and recognized over the specific time period. Our contracts contain penalty clauses for early termination. Although our contracts have stated terms of one or more years, under ASC 606 our contracts are considered month to month and accordingly, there is no financing component. Disaggregation of Revenue from Contracts with Customers We derive revenue from six primary sources: medical billing services, ancillary services, printing and mailing, clearinghouse and EDI (electronic data interchange) services, Enrollment Plus TM The following table represents a disaggregation of revenue for the three and six months ended June 30: Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Medical billing revenue $ 7,866,650 $ 7,013,263 $ 15,259,040 $ 14,345,898 Ancillary services 313,454 251,104 562,091 534,761 Printing and mailing 301,279 294,627 649,523 641,420 Clearinghouse and EDI services 141,901 185,842 335,340 372,177 Enrollment Plus 19,200 - 102,857 - Professional services 40,453 39,914 81,411 110,568 Total $ 8,682,937 $ 7,784,750 $ 16,990,262 $ 16,004,824 We apply the portfolio approach as permitted by ASC 606 as a practical expedient to contracts with similar characteristics and we use estimates and assumptions when accounting for those portfolios. Our contracts generally include standard commercial payment terms. We have no significant obligations for refunds, warranties or similar obligations and our revenue does not include taxes collected from our customers. Medical billing revenue: Medical billing is the recurring process of submitting and following up on claims with health insurance companies in order for the healthcare providers to receive payment for the services they rendered. MTBC invoices customers on a monthly basis based on the actual collections received by its customers and the agreed-upon rate in the sales contract. The series of services under medical billing revenue includes practice management software and related tools, electronic health records, revenue cycle management services and mobile health solutions. We consider the series of services provided under our medical billing contracts to be one performance obligation since the promises are not distinct in the context of the contract. Substantially all of our medical billing contracts contain variable consideration and we estimate the variable consideration which we expect to be entitled to over the contractual period associated with our medical billing contracts, which begins no earlier than go-live and recognize the fees over the term. When a contract includes variable consideration, we evaluate the estimate of the variable consideration to determine whether the estimate needs to be constrained; therefore, we include the variable consideration in the transaction price only to the extent that it is probable that a significant reversal of the amount of cumulative revenue recognized will not occur when the uncertainty associated with the variable consideration is subsequently resolved. For the majority of our medical billing contracts, the total contractual price is variable because our obligation is to process an unknown quantity of transactions, as and when requested by our customers, over the contract period. We allocate the variable price to each claim processed using the time-series concept and recognize revenue based on the most likely amount of consideration to which we will be entitled to, which is generally the amount we have the right to invoice. Estimates to determine the variable consideration such as payment to charge ratios, effective billing rates, and the estimated contractual payment periods are updated at each reporting date. The contract asset in the condensed consolidated balance sheet represents the revenue associated with the amounts our clients will ultimately collect associated with the services they have provided and the relative fee we charge associated with those collections. The performance obligations as of January 1, 2018 were substantially recognized in the quarter ended March 31, 2018. As of June 30, 2018, the estimated revenue expected to be recognized in the future related to the remaining performance obligations was approximately $1.7 million. As of June 30, 2018, the Company determined the contract asset for a significant customer, where the information was previously unavailable. Of the total contract asset at June 30, 2018, approximately $210,000 was related to this customer. We expect to recognize substantially all of the revenue for the remaining performance obligations over the next 3 months. Our medical billing performance obligations consist of a series of distinct services that are substantially the same and have the same periodic pattern of transfer to our customers. We consider each periodic rendering of service to be a distinct performance obligation and, accordingly, recognize revenue over time. Other revenue streams: Ancillary services represent services such as coding and transcription that are rendered in connection with the delivery of medical billing and related services. The Company invoices customers monthly, based on the actual amount of services performed at the agreed upon rate in the contract. These services are only offered to medical billing customers. These services do not represent a material right because the services are optional to the customer and customers electing these services are charged the same price for those services as if they were on a standalone basis. Each individual coding or transcription transaction processed represents a performance obligation, which is satisfied once that individual service is completed. The Company provides printing and mailing services for a non-medical billing customer and invoices on a monthly basis based on the number of prints, the agreed-upon rate per print and the postage incurred. The performance obligation is satisfied once the printing and mailing is completed. The medical billing clearinghouse takes claim information from customers, checks the claims for errors and sends this information electronically to insurance companies. MTBC invoices customers on a monthly basis based on the number of claims submitted and the agreed-upon rate in the agreement. This service is provided to non-medical billing customers. The performance obligation is satisfied once the relevant submissions are completed. MTBC also provides implementation and professional services to clearinghouse customers and records revenue monthly on a time and materials basis. This is a separate performance obligation from the clearinghouse and EDI services provided. The performance obligation is satisfied once the implementation or professional service is completed. For the Enrollment Plus Plus For all of the above revenue streams, revenue is recognized over time, when invoiced, which closely matches point in time recognition, as the customer simultaneously receives and consumes the benefits provided by the Company. Each of the services provided above is considered a separate performance obligation and is satisfied over time, which is typically one month or less. Information about contract balances: Accounts receivable are shown separately at their net realizable value in our condensed consolidated balance sheets. Amounts that we are entitled to collect under the applicable contract are recorded as accounts receivable. Invoicing is performed at the end of each month when the services have been provided. The contract asset results from our medical billing services and is due to the timing of revenue recognition, submission of claims from our customers and payments from the insurance providers. The contract asset includes our right to payment for services already transferred to a customer when the right to payment is conditional on something other than the passage of time. For example, contracts for medical billing services where we recognize revenue over time but do not have a contractual right to payment until the customer receives payment of their claim from the insurance provider. The contract asset was approximately $1.7 million as of June 30, 2018. Changes in the contract asset are recorded as adjustments to net revenues and primarily result from providing services to customers that result in additional consideration and are offset by our right to payment for services becoming unconditional. Deferred revenue represents sign-up fees received from customers that are amortized over 3 years. The opening and closing balances of the Company’s accounts receivable, contract asset and deferred revenue are as follows: Accounts Receivable, Net Contract Asset Deferred Revenue (current) Deferred Revenue (long term) Beginning balance as of January 1, 2018 $ 3,879,463 $ 1,342,692 $ 62,104 $ 28,615 (Decrease) increase, net (441,613 ) 326,631 (34,429 ) (403 ) Ending balance as of June 30, 2018 $ 3,437,850 $ 1,669,323 $ 27,675 $ 28,212 Deferred commissions: Our sales incentive plans include commissions payable to employees and third parties at the time of initial contract execution that are capitalized as incremental costs to obtain a contract. The capitalized commissions are amortized over the period the related services are transferred. Amortization of the capitalized commissions was $14,000 and $26,000 for the three and six months ended June 30, 2018, respectively. As we do not offer commissions on contract renewals, we have determined the amortization period to be the estimated client life, which is three years. Deferred commissions were approximately $113,000 at June 30, 2018 and are included in the Other Assets lines in our condensed consolidated balance sheets.

Stock-Based Compensation

Stock-Based Compensation	6 Months Ended
	Jun. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Stock-Based Compensation	10. STOCK-BASED COMPENSATION In April 2014, the Company adopted its Equity Incentive Plan, reserving 1,351,000 shares of common stock for grants to employees, officers, directors and consultants. During April 2017, this plan was amended and restated whereby an additional 1,500,000 shares of common stock and 100,000 shares of Series A Preferred Stock were added to the plan for future issuance. During June 2018, the Company’s shareholders approved the addition of 200,000 preferred shares to the Equity Incentive Plan for future grants. As of June 30, 2018, 985,700 shares of common stock and 227,200 shares of Series A Preferred Stock are available for grant under our equity incentive plan. Permissible awards include incentive stock options, non-statutory stock options, stock appreciation rights, restricted stock, RSUs, performance stock and cash-settled awards and other stock-based awards in the discretion of the Compensation Committee of the Board of Directors including unrestricted stock grants. The equity based RSUs contain a provision in which the units shall immediately vest and become converted into common shares at the rate of one common share per RSU, immediately after a change in control, as defined in the award agreement. Common stock RSUs During May 2018, a total of 150,000 RSUs of common stock were granted equally to two executive officers. The RSUs vest in one-third increments over the next 15 months from the grant date. During the third quarter of 2017, a total of 200,000 RSUs of common stock were granted equally to the four outside members of the Board of Directors and a total of 300,000 RSUs of common stock were granted equally to three executive officers. The RSUs vest over the next two years, at six month intervals. The following table summarizes the RSU transactions related to the common stock under our equity incentive plan for the six months ended June 30, 2018: Outstanding and unvested at January 1, 2018 605,969 Granted 231,200 Vested (150,482 ) Forfeited (5,666 ) Outstanding and unvested at June 30, 2018 681,021 Of the total outstanding and unvested at June 30, 2018, 591,251 RSUs are classified as equity and 89,770 RSUs are classified as a liability. The liability for the cash-settled awards was approximately $45,000 and $41,000 at June 30, 2018 and December 31, 2017, respectively, and is included in accrued compensation in the condensed consolidated balance sheets. Stock-based compensation expense The Company recognizes compensation expense on a straight-line basis over the total requisite service period for the entire award. For stock awards classified as equity, the market price of our common stock or preferred stock on the date of grant is used in recording the fair value of the award. For stock awards classified as a liability, the earned amount is marked to market based on the end of period common stock price. In 2017, the Compensation Committee of the Board of Directors approved executive bonuses to be paid in shares of Series A Preferred Stock, with the number of shares and the value based on specified criteria being achieved during the year. The Company accrued for this expense as based on the probable amount to be paid. In 2018, the Compensation Committee has again approved executive bonuses to be paid in shares of Series A Preferred Stock, with the number of shares and the amount based on specified criteria being achieved during 2018. The achievement of these criteria will be determined after the year-end. Once the Company’s shareholders added additional shares of preferred stock to the Equity Incentive Plan, the Company begun accruing for 2018 bonuses based on the probability of achieving the results. During the quarter ended June 30, 2018, approximately $154,000 was accrued for the 2018 stock bonuses and is included in stock based compensation expense. The following table summarizes the components of share-based compensation expense for the three and six months ended June 30, 2018 and 2017: Stock-based compensation included in the Three Months Ended June 30, Six Months Ended June 30, Condensed Consolidated Statement of Operations: 2018 2017 2018 2017 Direct operating costs $ 8,475 $ 2,680 $ 9,859 $ 5,457 General and administrative 396,674 68,791 522,600 194,081 Research and development 4,563 7,218 4,944 8,497 Total stock-based compensation expense $ 409,712 $ 78,689 $ 537,403 $ 208,035

Income Taxes

Income Taxes	6 Months Ended
	Jun. 30, 2018
Income Tax Disclosure [Abstract]
Income Taxes	11. INCOME TAXES The current income tax provision for the six months ended June 30, 2018 and 2017 primarily relates to state minimum taxes and foreign income taxes. The deferred income tax provision for the six months ended June 30, 2018 and 2017 relates to the amortization of goodwill. Although the Company is forecasting a return to profitability, it has not had sufficient history of profitable operations which makes realization of a deferred tax asset difficult to support in accordance with ASC 740. Accordingly, a valuation allowance has been recorded against all Federal and state deferred tax assets as of June 30, 2018 and December 31, 2017. The valuation allowance has been applied to the net deferred tax assets and liabilities excluding the deferred tax liability related to the amortization of goodwill. On December 22, 2017, the Tax Cuts and Jobs Act (the “Act”) was enacted. Effective January 1, 2018, among other changes, the Act (a) reduces the U.S. federal corporate tax rate to 21 percent, provides for a deemed repatriation and taxation at reduced rates on historical earnings (a “Transition Tax”) of certain non-US subsidiaries owned by U.S. companies and establishes new mechanisms to tax such earnings going forward. For the Transition Tax, we are finalizing the estimated amount of accumulated foreign earnings. We expect to complete our analysis within the measurement period in accordance with Staff Accounting Bulletin (“SAB”) 118. The Act includes a provision effective January 1, 2018 for a global intangible low-taxed income (“GILTI”) tax, which is a new U.S. income inclusion of certain foreign earnings under the Subpart F tax regulations, but ultimately allowable to be offset by the Company’s available net operating loss carryover. Companies can account for the GILTI inclusion in either the period incurred or establish deferred tax liabilities for the expected future taxes associated with accumulated GILTI. The Company elected to record the GILTI provisions as they are incurred each period. For the three and six months ended June 30, 2018, no GILTI tax liability was recorded. The Company will continue to analyze the effects of the Act on its consolidated financial statements and operations. Our estimates are subject to change as we review the data available and any additional guidance. Any additional impacts from the enactment of the Act will be recorded as they are identified during the measurement period as provided in SAB 118. No provisional amounts were recorded during the six months ended June 30, 2018. We expect to conclude our analysis by the end of the third quarter.

Restructuring Charges

Restructuring Charges	6 Months Ended
	Jun. 30, 2018
Restructuring and Related Activities [Abstract]
Restructuring Charges	12. RESTRUCTURING CHARGES During March 2017, the Company decided to close its operations in Poland and India. In connection with the closing of these subsidiaries, in the first quarter of 2017, the Company expensed approximately $276,000 of restructuring charges representing primarily employee severance costs, remaining lease and termination fees, disposal of property and equipment and professional fees. The Company does not expect to record any additional restructuring charges for these closures.

Fair Value of Financial Instrum

Fair Value of Financial Instruments	6 Months Ended
	Jun. 30, 2018
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	13. FAIR VALUE OF FINANCIAL INSTRUMENTS As of June 30, 2018 and December 31, 2017, the carrying amounts of receivables, accounts payable and accrued expenses approximated their estimated fair values because of the short term nature of these financial instruments. Fair value measurements-Level 2 Our notes payable are carried at cost and approximate fair value since the interest rates being charged approximate market rates. Contingent Consideration The Company’s contingent consideration of approximately $563,000 and $603,000 as of June 30, 2018 and December 31, 2017, respectively, are Level 3 liabilities. The fair value of the contingent consideration at June 30, 2018 and December 31, 2017 was primarily driven by changes in revenue estimates related to the acquisitions during 2015 and 2016, the passage of time and the associated discount rate. Due to the number of factors used to determine contingent consideration, it is not possible to determine a range of outcomes. Subsequent adjustments to the fair value of the contingent consideration liability will continue to be recorded in the Company’s results of operations until all contingencies are settled. The following table provides a reconciliation of the beginning and ending balances for the contingent consideration measured at fair value using significant unobservable inputs (Level 3): Fair Value Measurement at Reporting Date Using Significant Unobservable Inputs, Level 3 Six Months Ended June 30, 2018 2017 Balance - January 1, $ 603,411 $ 929,549 Change in fair value 42,780 151,423 Settlement in the form of shares issued - (331,676 ) Payments (82,725 ) (33,114 ) Balance - June 30, $ 563,466 $ 716,182

Subsequent Event

Subsequent Event	6 Months Ended
	Jun. 30, 2018
Subsequent Events [Abstract]
Subsequent Event	15. SUBSEQUENT EVENT On May 4, 2018, the Company executed an asset purchase agreement (“APA”) to acquire substantially all of the revenue cycle, practice management, and group purchasing organization assets of Orion. The acquisition was approved through a sale order dated June 29, 2018 by the United States Bankruptcy Court for the Eastern District of New York as a Section 363 purchase under Chapter 11 of the U.S. Bankruptcy Code. The final purchase price was $12.6 million. The final APA was approved by the Bankruptcy Court, with an effective date of July 1, 2018. We expect that this acquisition will be accounted for as a business combination.

Basis of Presentation (Tables)

Basis of Presentation (Tables)	6 Months Ended
	Jun. 30, 2018
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Schedule Prior Adjustments for Implements to New Revenue Recognition	The following table reconciles the balances as presented for the three and six months ended June 30, 2018 to the balances prior to the adjustments made to implement the new revenue recognition standard for the same period: Three Months Ended June 30, 2018 Six Months Ended June 30, 2018 As Presented Impact of New Revenue Standard Previous Revenue Standard As Presented Impact of New Revenue Standard Previous Revenue Standard NET REVENUE $ 8,682,937 $ 279,560 $ 8,403,377 $ 16,990,262 $ 326,631 $ 16,663,631 OPERATING EXPENSES: Direct operating costs 4,333,573 - 4,333,573 8,817,628 - 8,817,628 Selling and marketing 403,057 (7,688 ) 410,745 708,071 (11,225 ) 719,296 General and administrative 3,054,205 - 3,054,205 5,654,939 - 5,654,939 Research and development 248,921 - 248,921 504,800 - 504,800 Change in contingent consideration 11,030 - 11,030 42,780 - 42,780 Depreciation and amortization 559,696 - 559,696 1,150,467 - 1,150,467 Total operating expenses 8,610,482 (7,688 ) 8,618,170 16,878,685 (11,225 ) 16,889,910 OPERATING INCOME (LOSS) 72,455 287,248 (214,793 ) 111,577 337,856 (226,279 ) OTHER: Interest income 29,939 - 29,939 35,224 - 35,224 Interest expense (74,167 ) - (74,167 ) (148,248 ) - (148,248 ) Other income - net 218,589 - 218,589 369,963 - 369,963 INCOME BEFORE INCOME TAXES 246,816 287,248 (40,432 ) 368,516 337,856 30,660 Income tax provision 51,536 - 51,536 98,200 - 98,200 NET INCOME (LOSS) $ 195,280 $ 287,248 $ (91,968 ) $ 270,316 $ 337,856 $ (67,540 ) Preferred stock dividend 1,248,717 - 1,248,717 2,024,049 - 2,024,049 NET (LOSS) INCOME ATTRIBUTABLE TO COMMON SHAREHOLDERS $ (1,053,437 ) $ 287,248 $ (1,340,685 ) $ (1,753,733 ) $ 337,856 $ (2,091,589 ) Loss per common share: Basic and diluted (loss) income per share $ (0.09 ) $ 0.02 $ (0.11 ) $ (0.15 ) $ 0.03 $ (0.18 )

Acquisition (Tables)

Acquisition (Tables)	6 Months Ended
	Jun. 30, 2018
Business Combinations [Abstract]
Business Acquisition, Pro Forma Information	Pro forma information for the three and six months ended June 30, 2018 is not presented as there was no acquisition which was not fully reflected in the Company’s condensed consolidated financial statements during those periods. Three Months Ended Six Months Ended June 30, 2017 June 30, 2017 Total revenue $ 8,041 $ 16,523 Net loss attributable to common shareholders $ (2,108 ) $ (5,003 ) Net loss per common share $ (0.19 ) $ (0.48 )

Goodwill and Intangible Asset24

Goodwill and Intangible Assets-Net (Tables)	6 Months Ended
	Jun. 30, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets and Goodwill	The following is the summary of the changes to the carrying amount of goodwill for the six months ended June 30, 2018 and the year ended December 31, 2017: June 30, 2018 December 31, 2017 Beginning gross balance $ 12,263,943 $ 12,178,868 Acquisition - 85,075 Ending gross balance $ 12,263,943 $ 12,263,943
Schedule of Finite-Lived Intangible Assets	Intangible assets - net as of June 30, 2018 and December 31, 2017 consist of the following: June 30, 2018 December 31, 2017 Contracts and relationships acquired $ 16,491,300 $ 16,491,300 Non-compete agreements 1,236,377 1,236,377 Other intangible assets 1,521,664 1,498,417 Total intangible assets 19,249,341 19,226,094 Less: Accumulated amortization (17,547,101 ) (16,716,550 ) Intangible assets - net $ 1,702,240 $ 2,509,544
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	As of June 30, 2018, future amortization scheduled to be expensed is as follows: Years Ending December 31 2018 (six months) $ 737,104 2019 850,389 2020 103,127 2021 11,620 Total $ 1,702,240

Net Loss Per Common Share (Tabl

Net Loss Per Common Share (Tables)	6 Months Ended
	Jun. 30, 2018
Loss per common share:
Schedule of Losses Per Share, Basic and Diluted	The following table presents the basic and diluted net loss per weighted-average shares outstanding for the three and six months ended June 30, 2018 and 2017: Three Months Ended Six Months Ended June 30, June 30, 2018 2017 2018 2017 Basic and Diluted: Net loss attributable to common shareholders $ (1,053,437 ) $ (2,121,478 ) $ (1,753,733 ) $ (5,032,002 ) Weighted average shares applicable to common shareholders used in computing basic and diluted loss per share 11,665,174 10,833,075 11,641,190 10,504,417 Net loss attributable to common shareholders per share - Basic and Diluted $ (0.09 ) $ (0.20 ) $ (0.15 ) $ (0.48 )

Commitments and Contingencies (

Commitments and Contingencies (Tables)	6 Months Ended
	Jun. 30, 2018
Commitments and Contingencies Disclosure [Abstract]
Schedule of Future Minimum Lease Payments Under Non-cancelable Operating Leases	Future minimum lease payments under non-cancelable operating leases for office space as of June 30, 2018 are as follows: Years Ending December 31 Total 2018 (six months) $ 158,055 2019 198,193 Total $ 356,248

Revenue (Tables)

Revenue (Tables)	6 Months Ended
	Jun. 30, 2018
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	The following table represents a disaggregation of revenue for the three and six months ended June 30: Three Months Ended June 30, Six Months Ended June 30, 2018 2017 2018 2017 Medical billing revenue $ 7,866,650 $ 7,013,263 $ 15,259,040 $ 14,345,898 Ancillary services 313,454 251,104 562,091 534,761 Printing and mailing 301,279 294,627 649,523 641,420 Clearinghouse and EDI services 141,901 185,842 335,340 372,177 Enrollment Plus 19,200 - 102,857 - Professional services 40,453 39,914 81,411 110,568 Total $ 8,682,937 $ 7,784,750 $ 16,990,262 $ 16,004,824
Schedule of Accounts Receivable, Contract Asset and Deferred Revenue	The opening and closing balances of the Company’s accounts receivable, contract asset and deferred revenue are as follows: Accounts Receivable, Net Contract Asset Deferred Revenue (current) Deferred Revenue (long term) Beginning balance as of January 1, 2018 $ 3,879,463 $ 1,342,692 $ 62,104 $ 28,615 (Decrease) increase, net (441,613 ) 326,631 (34,429 ) (403 ) Ending balance as of June 30, 2018 $ 3,437,850 $ 1,669,323 $ 27,675 $ 28,212

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	6 Months Ended
	Jun. 30, 2018
Disclosure of Compensation Related Costs, Share-based Payments [Abstract]
Disclosure of Share-based Compensation Arrangements by Share-based Payment Award	The following table summarizes the RSU transactions related to the common stock under our equity incentive plan for the six months ended June 30, 2018: Outstanding and unvested at January 1, 2018 605,969 Granted 231,200 Vested (150,482 ) Forfeited (5,666 ) Outstanding and unvested at June 30, 2018 681,021
Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs	The following table summarizes the components of share-based compensation expense for the three and six months ended June 30, 2018 and 2017: Stock-based compensation included in the Three Months Ended June 30, Six Months Ended June 30, Condensed Consolidated Statement of Operations: 2018 2017 2018 2017 Direct operating costs $ 8,475 $ 2,680 $ 9,859 $ 5,457 General and administrative 396,674 68,791 522,600 194,081 Research and development 4,563 7,218 4,944 8,497 Total stock-based compensation expense $ 409,712 $ 78,689 $ 537,403 $ 208,035

Fair Value of Financial Instr29

Fair Value of Financial Instruments (Tables)	6 Months Ended
	Jun. 30, 2018
Fair Value Disclosures [Abstract]
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation	The following table provides a reconciliation of the beginning and ending balances for the contingent consideration measured at fair value using significant unobservable inputs (Level 3): Fair Value Measurement at Reporting Date Using Significant Unobservable Inputs, Level 3 Six Months Ended June 30, 2018 2017 Balance - January 1, $ 603,411 $ 929,549 Change in fair value 42,780 151,423 Settlement in the form of shares issued - (331,676 ) Payments (82,725 ) (33,114 ) Balance - June 30, $ 563,466 $ 716,182

Organization and Business (Deta

Organization and Business (Details Narrative)	Jun. 30, 2018
Founder and Executive Chairman [Member]
Equity method investment, ownership percentage in majority-owned subsidiary based in Pakistan	0.01%
MTBC [Member]
Equity method investment, ownership percentage in majority-owned subsidiary based in Pakistan	99.90%

Basis of Presentation (Details

Basis of Presentation (Details Narrative) - USD ($)	3 Months Ended	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Contract asset	$ 1,669,323	$ 1,669,323
Accumulated deficit	(21,794,949)	(21,794,949)		$ (23,509,386)
Capitalized sales commissions		113,000
Amortization of sales commissions	14,000	26,472
January 1, 2018 [Member]
Contract asset	1,300,000	1,300,000
Accumulated deficit	$ 101,000	$ 101,000

Basis of Presentation - Schedul

Basis of Presentation - Schedule Prior Adjustments for Implements to New Revenue Recognition (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
NET REVENUE	$ 8,682,937	$ 7,784,750	$ 16,990,262	$ 16,004,824
Direct operating costs	4,333,573	4,197,824	8,817,628	9,420,560
Selling and marketing	403,057	268,958	708,071	624,469
General and administrative	3,054,205	2,771,811	5,654,939	5,758,474
Research and development	248,921	313,400	504,800	594,249
Change in contingent consideration	11,030	162,611	42,780	151,423
Depreciation and amortization	559,696	1,453,145	1,150,467	2,972,690
Total operating expenses	8,610,482	9,167,749	16,878,685	19,797,493
OPERATING INCOME (LOSS)	72,455	(1,382,999)	111,577	(3,792,669)
Interest income	29,939	4,731	35,224	8,152
Interest expense	(74,167)	(285,144)	(148,248)	(564,569)
Other income - net	218,589	36,839	369,963	74,870
INCOME BEFORE INCOME TAXES	246,816	(1,626,573)	368,516	(4,274,216)
Income tax provision	51,536	67,030	98,200	127,332
NET INCOME (LOSS)	195,280	(1,693,603)	270,316	(4,401,548)
Preferred stock dividend	1,248,717	427,875	2,024,049	630,454
NET (LOSS) INCOME ATTRIBUTABLE TO COMMON SHAREHOLDERS	$ (1,053,437)	$ (2,121,478)	$ (1,753,733)	$ (5,032,002)
Basic and diluted (loss) income per share	$ (0.09)	$ (0.20)	$ (0.15)	$ (0.48)
Impact of New Revenue Standard [Member]
NET REVENUE	$ 279,560		$ 326,631
Direct operating costs
Selling and marketing	(7,688)		(11,225)
General and administrative
Research and development
Change in contingent consideration
Depreciation and amortization
Total operating expenses	(7,688)		(11,225)
OPERATING INCOME (LOSS)	287,248		337,856
Interest income
Interest expense
Other income - net
INCOME BEFORE INCOME TAXES	287,248		337,856
Income tax provision
NET INCOME (LOSS)	287,248		337,856
Preferred stock dividend
NET (LOSS) INCOME ATTRIBUTABLE TO COMMON SHAREHOLDERS	$ 287,248		$ 337,856
Basic and diluted (loss) income per share	$ 0.02		$ 0.03
Previous Revenue Standard [Member]
NET REVENUE	$ 8,403,377		$ 16,663,631
Direct operating costs	4,333,573		8,817,628
Selling and marketing	410,745		719,296
General and administrative	3,054,205		5,654,939
Research and development	248,921		504,800
Change in contingent consideration	11,030		42,780
Depreciation and amortization	559,696		1,150,467
Total operating expenses	8,618,170		16,889,910
OPERATING INCOME (LOSS)	(214,793)		(226,279)
Interest income	29,939		35,224
Interest expense	(74,167)		(148,248)
Other income - net	218,589		369,963
INCOME BEFORE INCOME TAXES	(40,432)		30,660
Income tax provision	51,536		98,200
NET INCOME (LOSS)	(91,968)		(67,540)
Preferred stock dividend	1,248,717		2,024,049
NET (LOSS) INCOME ATTRIBUTABLE TO COMMON SHAREHOLDERS	$ (1,340,685)		$ (2,091,589)
Basic and diluted (loss) income per share	$ (0.11)		$ (0.18)

Acquisition (Details Narrative)

Acquisition (Details Narrative) - USD ($)	May 04, 2018	Jun. 30, 2018	Jun. 30, 2018	Jun. 30, 2018	Jul. 01, 2017
Aggregate purchase price	$ 12,600,000
Revenue earned from the WMB acquisition		$ 47,000	$ 113,000
Asset Purchase Agreement [Member] | Washington Medical Billing, LLC [Member]
Non-refundable initial payment amount					$ 205,000
Aggregate purchase price				$ 205,000

Acquisition - Business Acquisit

Acquisition - Business Acquisition, Pro Forma Information (Details) - USD ($)	3 Months Ended	6 Months Ended
	Jun. 30, 2017	Jun. 30, 2017
Business Combinations [Abstract]
Total revenue	$ 8,041	$ 16,523
Net loss attributable to common shareholders	$ (2,108)	$ (5,003)
Net loss per common share	$ (0.19)	$ (0.48)

Goodwill and Intangible Asset35

Goodwill and Intangible Assets-Net (Details Narrative) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization expenses	$ 415,000	$ 1,300,000	$ 854,000	$ 2,600,000

Goodwill and Intangible Asset36

Goodwill and Intangible Assets-Net - Schedule of Intangible Assets and Goodwill (Details) - USD ($)	6 Months Ended	12 Months Ended
	Jun. 30, 2018	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
Beginning gross balance	$ 12,263,943	$ 12,178,868
Acquisition		85,075
Ending gross balance	$ 12,263,943	$ 12,263,943

Goodwill and Intangible Asset37

Goodwill and Intangible Assets-Net - Schedule of Finite-Lived Intangible Assets (Details) - USD ($)	Jun. 30, 2018	Dec. 31, 2017
Finite-Lived Intangible Assets [Line Items]
Total intangible assets, gross	$ 19,249,341	$ 19,226,094
Less: Accumulated amortization	(17,547,101)	(16,716,550)
Intangible assets - net	1,702,240	2,509,544
Contracts and Relationships Acquired [Member]
Finite-Lived Intangible Assets [Line Items]
Total intangible assets, gross	16,491,300	16,491,300
Non-Compete Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Total intangible assets, gross	1,236,377	1,236,377
Other Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Total intangible assets, gross	$ 1,521,664	$ 1,498,417

Goodwill and Intangible Asset38

Goodwill and Intangible Assets-Net - Schedule of Finite-Lived Intangible Assets, Future Amortization Expense (Details) - USD ($)	Jun. 30, 2018	Dec. 31, 2017
Goodwill and Intangible Assets Disclosure [Abstract]
2018 (Six months)	$ 737,104
2,019	850,389
2,020	103,127
2,021	11,620
Total	$ 1,702,240	$ 2,509,544

Net Loss Per Common Share (Deta

Net Loss Per Common Share (Details Narrative) - shares	6 Months Ended
	Jun. 30, 2017	Oct. 31, 2017
SVB Credit Facility Agreement [Member]
Antidilutive securities excluded from computation of earning per share, warrants		125,000
Opus Bank [Member]
Antidilutive securities excluded from computation of earning per share, warrants	200,000
Number of warrant issued	2,000,000
Antidilutive securities excluded from computation expiration	May 2,018

Net Loss Per Common Share - Sch

Net Loss Per Common Share - Schedule of Losses Per Share, Basic and Diluted (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Loss per common share:
Net loss attributable to common shareholders	$ (1,053,437)	$ (2,121,478)	$ (1,753,733)	$ (5,032,002)
Weighted average shares applicable to common shareholders used in computing basic and diluted loss per share	11,665,174	10,833,075	11,641,190	10,504,417
Net loss attributable to common shareholders per share - Basic and Diluted	$ (0.09)	$ (0.20)	$ (0.15)	$ (0.48)

Debt (Details Narrative)

Debt (Details Narrative) - USD ($)	Sep. 02, 2015	Oct. 31, 2017	Jun. 30, 2018
Opus Bank Loan [Member] | Term Loan [Member]
Credit facility, maximum borrowing capacity	$ 8,000,000
Opus Bank Loan [Member] | Total [Member]
Credit facility, maximum borrowing capacity	$ 10,000,000
Percentage of shares secured for debt	65.00%
Vehicle Financing Notes [Member]
Vehicle financing in United stated and Pakistan			three to six year terms
Insurance Financing [Member]
Insurance purchases, interest rate, stated percentage			5.25%
SVB Debt Agreement [Member]
Payment of upfront fees		$ 50,000
Class of warrant or right, number of securities called by warrants or rights		125,000
Payments for annual anniversary fee		$ 50,000
Warrant strike price		$ 3.92
Warrant exercise term		5 years
Warrants price per share		$ 3.12
SVB Credit Facility [Member]
Revolving line of credit		$ 5,000,000
Secured revolving line of credit percentage		200.00%
Revolving line of credit, interest rate - Prime plus		1.75%
Unused portion of credit line fee, percentage		0.50%
Percentage of shares in offshore facilities		65.00%
Revolving Credit Facility [Member] | Opus Bank Loan [Member]
Credit facility, maximum borrowing capacity	$ 2,000,000

Commitments and Contingencies42

Commitments and Contingencies (Details Narrative) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Operating leases expire year			expiring through 2021.
Operating leases, rent expense	$ 220,000	$ 224,000	$ 436,000	$ 453,000
Off Shore Lease [Member]
Lease monthly rental payments			21,000
US Corporate Facility and Other Locations [Member]
Monthly rent expense of month to month leases			$ 12,000

Commitments and Contingencies -

Commitments and Contingencies - Schedule of Future Minimum Lease Payments Under Non-cancelable Operating Leases (Details) - Years Ending December 31 [Member]	Jun. 30, 2018USD ($)
2018 (six months)	$ 158,055
2,019	198,193
Total	$ 356,248

Related Parties (Details Narrat

Related Parties (Details Narrative) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Revenues	$ 8,682,937	$ 7,784,750	$ 16,990,262	$ 16,004,824
Operating leases, rent expense	220,000	224,000	436,000	453,000
Accrued liability to related party	10,663		10,663		$ 10,675
Kashmir Air, Inc [Member]
Operating leases, rent expense	32,000	32,000	64,000	64,000
Accrued liability to related party	11,000		11,000		11,000
Physician [Member]
Revenues	4,000	4,000	9,000	8,000
Receivable balance due from this customer	1,400		1,400		1,900
Founder and Executive Chairman [Member]
Operating leases, rent expense	47,000	$ 47,000	95,000	$ 94,000
Security deposit	13,000		13,000		13,000
Prepaid rent	$ 12,000		$ 12,000		$ 12,000

Revenue (Details Narrative)

Revenue (Details Narrative) - USD ($)	3 Months Ended	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2018	Jun. 30, 2017	Dec. 31, 2017
Revenue from Contract with Customer [Abstract]
Remaining performance obligations	$ 1,700,000	$ 1,700,000
Contract asset related to a significant customer	210,000	210,000
Contract asset	$ 1,669,323	$ 1,669,323
Estimated recognition period for remaining performance obligations	3 months	3 months
Sign-up fees received from customers		amortized over 3 years
Amortization of sales commissions	$ 14,000	$ 26,472
Deferred commissions		$ 113,000

Revenue - Schedule of Disaggreg

Revenue - Schedule of Disaggregation of Revenue (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Net revenue	$ 8,682,937	$ 7,784,750	$ 16,990,262	$ 16,004,824
Medical Billing Revenue [Member]
Net revenue	7,866,650	7,013,263	15,259,040	14,345,898
Ancillary Services [Member]
Net revenue	313,454	251,104	562,091	534,761
Printing and Mailing [Member]
Net revenue	301,279	294,627	649,523	641,420
Clearing House and EDI Services [Member]
Net revenue	141,901	185,842	335,340	372,177
Enrollment Plus [Member]
Net revenue	19,200		102,857
Professional Services [Member]
Net revenue	$ 40,453	$ 39,914	$ 81,411	$ 110,568

Revenue - Schedule of Accounts

Revenue - Schedule of Accounts Receivable, Contract Asset and Deferred Revenue (Details) - USD ($)	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Accounts receivable net, beginning balance	$ 3,879,463
Accounts receivable (Decrease) increase, net	(329,207)	$ (530,913)
Accounts receivable net, ending balance	3,437,850
Contract asset, beginning balance
Contract asset, ending balance	1,669,323
Deferred revenue(current), beginning balance	62,104
Deferred revenue(current)(Decrease)/ increase, net	(34,832)	$ 659
Deferred revenue(current), ending balance	27,675
Deferred revenue(long term), beginning balance	28,615
Deferred revenue(long term), ending balance	28,212
Contract Balances [Member]
Accounts receivable net, beginning balance	3,879,463
Accounts receivable (Decrease) increase, net	(441,613)
Accounts receivable net, ending balance	3,437,850
Contract asset, beginning balance	1,342,692
Contract asset (Decrease)/ increase, net	326,631
Contract asset, ending balance	1,669,323
Deferred revenue(current), beginning balance	62,104
Deferred revenue(current)(Decrease)/ increase, net	(34,429)
Deferred revenue(current), ending balance	27,675
Deferred revenue(long term), beginning balance	28,615
Deferred revenue(long term) (Decrease)/ increase, net	(403)
Deferred revenue(long term), ending balance	$ 28,212

Stock-Based Compensation (Detai

Stock-Based Compensation (Details Narrative) - USD ($)	Apr. 30, 2017	May 31, 2018	Sep. 30, 2017	Jun. 30, 2018	Dec. 31, 2017	Apr. 30, 2014
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Accrued compensation				$ 1,033,945	$ 1,137,351
Accrued stock bonus				$ 154,000
Restricted Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period				231,200
Unvested stock option award, equity				591,251
Restricted stock award classified as liability				89,770
Accrued compensation				$ 45,000	$ 41,000
Amended and Restated Equity Incentive Plan [Member] | Restricted Shares [Member] | Four Outsides Members of the Board [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period			200,000
Amended and Restated Equity Incentive Plan [Member] | Series A Preferred Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Number of shares added to amended and restated equity incentive plan	100,000
Number of shares available for grant				227,200
Number of new shares addition to the plan for future grants				200,000
Amended and Restated Equity Incentive Plan [Member] | Common Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Number of shares added to amended and restated equity incentive plan	1,500,000
Number of shares available for grant				985,700
Amended and Restated Equity Incentive Plan [Member] | Employees Officers Directors and Consultants [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share-based compensation arrangement by share-based payment award, number of shares authorized						1,351,000
Amended and Restated Equity Incentive Plan [Member] | Two Executive Officers [Member] | Restricted Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period		150,000
Amended and Restated Equity Incentive Plan [Member] | Three Executive Officers [Member] | Restricted Shares [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period			300,000

Stock-Based Compensation - Disc

Stock-Based Compensation - Disclosure of Share-based Compensation Arrangements by Share-based Payment Award (Details) - Restricted Shares [Member]	6 Months Ended
	Jun. 30, 2018shares
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding and unvested at beginning	605,969
Granted	231,200
Vested	(150,482)
Forfeited	(5,666)
Outstanding and unvested at ending	681,021

Stock-Based Compensation - Sche

Stock-Based Compensation - Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs (Details) - USD ($)	3 Months Ended		6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Jun. 30, 2018	Jun. 30, 2017
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	$ 409,712	$ 78,689	$ 537,403	$ 208,035
Direct Operating Costs [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	8,475	2,680	9,859	5,457
General and Administrative [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	396,674	68,791	522,600	194,081
Research and Development [Member]
Share-based Compensation Arrangement by Share-based Payment Award, Compensation Cost [Line Items]
Total share-based compensation expense	$ 4,563	$ 7,218	$ 4,944	$ 8,497

Income Taxes (Details Narrative

Income Taxes (Details Narrative)	Dec. 22, 2017
Federal-Tax Cuts and Jobs Act [Member]
Federal statutory income tax rate	21.00%

Restructuring Charges (Details

Restructuring Charges (Details Narrative) - USD ($)	3 Months Ended			6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017	Mar. 31, 2017	Jun. 30, 2018	Jun. 30, 2017
Restructuring and Related Activities [Abstract]
Restructuring charges			$ 276,000		$ 275,628

Fair Value of Financial Instr53

Fair Value of Financial Instruments (Details Narrative) - USD ($)	Jun. 30, 2018	Dec. 31, 2017
Fair Value, Input, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Business combination, contingent consideration, liability	$ 563,000	$ 603,000

Fair Value of Financial Instr54

Fair Value of Financial Instruments - Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - Fair Value, Input, Level 3 [Member] - USD ($)	6 Months Ended
	Jun. 30, 2018	Jun. 30, 2017
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Balance, beginning	$ 603,411	$ 929,549
Change in fair value	42,780	151,423
Settlement in the form of shares issued		(331,676)
Payments	(82,725)	(33,114)
Balance, ending	$ 563,466	$ 716,182

Subsequent Event (Details Narra

Subsequent Event (Details Narrative)	May 04, 2018USD ($)
Subsequent Events [Abstract]
Business Acquisition price	$ 12,600,000