CareCloud (CCLD) 10-K 28 Feb 20 2019 FY Annual report Financial data

Document and Entity Information

Document and Entity Information - USD ($)	12 Months Ended
	Dec. 31, 2019	Feb. 27, 2020	Jun. 30, 2019
Document And Entity Information
Entity Registrant Name	MTBC, Inc.
Entity Central Index Key	0001582982
Document Type	10-K
Document Period End Date	Dec. 31, 2019
Amendment Flag	false
Current Fiscal Year End Date	--12-31
Entity Well-Known Seasoned Issuer	No
Entity Voluntary Filers	No
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business Flag	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Public Float			$ 31,400,000
Entity Common Stock, Shares Outstanding		12,335,930
Document Fiscal Period Focus	FY
Document Fiscal Year Focus	2019

Consolidated Balance Sheets

Consolidated Balance Sheets - USD ($)	Dec. 31, 2019	Dec. 31, 2018
CURRENT ASSETS:
Cash	$ 19,994,134	$ 14,472,483
Accounts receivable - net of allowance for doubtful accounts of $256,000 and $189,000 at December 31, 2019 and December 31, 2018, respectively	6,995,343	7,331,474
Contract asset	2,385,334	2,608,631
Inventory	491,088	444,437
Current assets - related party	13,200	25,203
Prepaid expenses and other current assets	1,123,036	1,191,445
Total current assets	31,002,135	26,073,673
Property and equipment - net	2,907,516	1,832,187
Operating lease right-of-use assets	3,526,315
Intangible assets - net	5,977,225	6,634,003
Goodwill	12,633,696	12,593,795
Other assets	356,578	489,703
TOTAL ASSETS	56,403,465	47,623,361
CURRENT LIABILITIES:
Accounts payable	3,490,834	2,438,267
Accrued compensation	1,836,309	1,731,063
Accrued expenses	2,111,515	1,589,009
Deferred rent (current portion)		90,657
Operating lease liability (current portion)	1,688,772
Deferred revenue (current portion)	20,277	25,355
Accrued liability to related party	663	10,663
Notes payable (current portion)	283,675	277,776
Contingent consideration		526,432
Dividend payable	1,745,791	1,468,724
Total current liabilities	11,177,836	8,157,946
Notes payable	83,275	222,400
Deferred rent		189,366
Operating lease liability	2,040,772
Deferred revenue	18,745	18,949
Deferred tax liability	244,512	164,346
Total liabilities	13,565,140	8,753,007
COMMITMENTS AND CONTINGENCIES (NOTE 11)
SHAREHOLDERS' EQUITY:
Preferred stock, $0.001 par value - authorized 7,000,000 and 4,000,000 shares at December 31, 2019 and December 31, 2018, respectively; issued and outstanding 2,539,325 and 2,136,289 shares at December 31, 2019 and December 31, 2018, respectively	2,539	2,136
Common stock, $0.001 par value - authorized 29,000,000 and 19,000,000 shares at December 31, 2019 and December 31, 2018, respectively; issued 12,978,485 and 12,570,557 shares at December 31, 2019 and December 31, 2018, respectively; 12,237,686 and 11,829,758 shares outstanding at December 31, 2019 and December 31, 2018, respectively	12,979	12,571
Additional paid-in capital	69,403,366	65,142,460
Accumulated deficit	(25,075,545)	(24,203,745)
Accumulated other comprehensive loss	(843,014)	(1,421,068)
Less: 740,799 common shares held in treasury, at cost at December 31, 2019 and December 31, 2018	(662,000)	(662,000)
Total shareholders' equity	42,838,325	38,870,354
TOTAL LIABILITIES AND SHAREHOLDERS' EQUITY	$ 56,403,465	$ 47,623,361

Consolidated Balance Sheets (Pa

Consolidated Balance Sheets (Parenthetical) - USD ($)	Dec. 31, 2019	Dec. 31, 2018
Statement of Financial Position [Abstract]
Allowance for doubtful accounts receivable	$ 256,000	$ 189,000
Preferred stock, par value	$ 0.001	$ 0.001
Preferred stock, shares authorized	7,000,000	4,000,000
Preferred stock, shares issued	2,539,325	2,136,289
Preferred stock, shares outstanding	2,539,325	2,136,289
Common stock, par value	$ 0.001	$ 0.001
Common stock, shares authorized	29,000,000	19,000,000
Common stock, shares issued	12,978,485	12,570,557
Common stock, shares outstanding	12,237,686	11,829,758
Treasury stock, shares	740,799	740,799

Consolidated Statements of Oper

Consolidated Statements of Operations - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Income Statement [Abstract]
NET REVENUE	$ 64,438,594	$ 50,545,781
OPERATING EXPENSES:
Direct operating costs	41,186,024	31,252,535
Selling and marketing	1,521,815	1,611,982
General and administrative	17,911,797	16,264,473
Research and development	870,780	1,029,510
Change in contingent consideration	(343,768)	73,271
Depreciation and amortization	3,005,606	2,853,827
Restructuring and impairment charges	219,013
Total operating expenses	64,371,267	53,085,598
OPERATING INCOME (LOSS)	67,327	(2,539,817)
OTHER:
Interest income	262,001	100,788
Interest expense	(382,673)	(351,168)
Other (expense) income - net	(625,675)	494,332
LOSS BEFORE PROVISION FOR INCOME TAXES	(679,020)	(2,295,865)
Income tax provision (benefit)	192,780	(157,385)
NET LOSS	(871,800)	(2,138,480)
Preferred stock dividend	6,386,154	4,823,987
NET LOSS ATTRIBUTABLE TO COMMON SHAREHOLDERS	$ (7,257,954)	$ (6,962,467)
Net loss per common share: basic and diluted	$ (0.60)	$ (0.59)
Weighted-average common shares used to compute basic and diluted loss per share	12,087,947	11,721,232

Consolidated Statements of Comp

Consolidated Statements of Comprehensive Loss - USD ($)		12 Months Ended
		Dec. 31, 2019	Dec. 31, 2018
Statement of Comprehensive Income [Abstract]
NET LOSS		$ (871,800)	$ (2,138,480)
OTHER COMPREHENSIVE INCOME (LOSS), NET OF TAX
Foreign currency translation adjustment	[1]	578,054	(699,998)
COMPREHENSIVE LOSS		$ (293,746)	$ (2,838,478)
[1]	No tax effect has been recorded as the Company recorded a valuation allowance against the tax benefit from its foreign currency translation adjustments.

Consolidated Statements of Shar

Consolidated Statements of Shareholders' Equity - 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
Net loss					(2,138,480)			(2,138,480)
Foreign currency translation adjustment						(699,998)		(699,998)
Issuance of stock under the equity incentive plan		$ 29	$ 299	(328)
Issuance of stock under the equity incentive plan, shares		29,550	299,167
Common stock warrants issued				101,989				101,989
Stock-based compensation, net of cash settlements				2,264,223				2,264,223
Tax withholding obligations on stock issued to employees				(345,500)				(345,500)
Issuance of preferred stock, net of fees and expenses		$ 1,020		22,816,546				22,817,566
Issuance of preferred stock, net of fees and expenses, shares		1,020,000
Preferred stock dividends	[1]			(4,823,987)				(4,823,987)
Balance at Dec. 31, 2018		$ 2,136	$ 12,571	65,142,460	(24,203,745)	(1,421,068)	(662,000)	38,870,354
Balance, shares at Dec. 31, 2018		2,136,289	12,570,557
Net loss					(871,800)			(871,800)
Foreign currency translation adjustment						578,054		578,054	[2]
Issuance of stock under the equity incentive plan		$ 30	$ 408	(438)
Issuance of stock under the equity incentive plan, shares		30,006	407,928
Stock-based compensation, net of cash settlements				1,920,533				1,920,533
Tax withholding obligations on stock issued to employees				(858,804)				(858,804)
Issuance of preferred stock, net of fees and expenses		$ 373		9,585,769				9,586,142
Issuance of preferred stock, net of fees and expenses, shares		373,030
Preferred stock dividends	[1]			(6,386,154)				(6,386,154)
Balance at Dec. 31, 2019		$ 2,539	$ 12,979	$ 69,403,366	$ (25,075,545)	$ (843,014)	$ (662,000)	$ 42,838,325
Balance, shares at Dec. 31, 2019		2,539,325	12,978,485
[1]	For all periods presented, the preferred stock dividends were paid monthly at the rate of $2.75 per share per annum.
[2]	No tax effect has been recorded as the Company recorded a valuation allowance against the tax benefit from its foreign currency translation adjustments.

Consolidated Statements of Sh_2

Consolidated Statements of Shareholders' Equity (Parenthetical) - $ / shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Statement of Stockholders' Equity [Abstract]
Preferred stock dividends paid monthly	$ 2.75	$ 2.75

Consolidated Statements of Cash

Consolidated Statements of Cash Flows - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2018
OPERATING ACTIVITIES:
Net loss	$ (871,800)	$ (2,138,480)	$ (2,138,480)
Adjustments to reconcile net loss to net cash provided by operating activities:
Depreciation and amortization	3,070,497	2,913,866
Deferred rent		(61,058)
Lease amortization	1,888,443
Deferred revenue	(5,282)	(46,415)
Provision for doubtful accounts	118,429	723,611
Provision (benefit) for deferred income taxes	80,166	(207,726)
Foreign exchange loss (gain)	827,121	(434,806)
Interest accretion	497,598	191,065
Gain on sale of assets	(38,388)
Stock-based compensation expense	3,215,661	2,463,599
Change in contingent consideration	(343,768)	73,271
Changes in operating assets and liabilities, net of businesses acquired:
Accounts receivable	765,079	1,479,297
Contract asset	362,466	(404,598)
Inventory	(46,651)	(137,159)
Other assets	(529,345)	248,347
Accounts payable and other liabilities	(1,372,239)	2,149,660
Net cash provided by operating activities	7,617,987	6,812,474
INVESTING ACTIVITIES:
Capital expenditures and capitalized software, net	(2,558,159)	(1,028,249)
Cash paid for acquisitions	(1,600,000)	(12,600,000)
Net cash used in investing activities	(4,158,159)	(13,628,249)
FINANCING ACTIVITIES:
Proceeds from issuance of preferred stock, net of fees and expenses	9,586,142	22,817,566
Preferred stock dividends paid	(6,109,087)	(4,102,410)
Settlement of tax withholding obligations on stock issued to employees	(1,391,746)	(333,007)
Proceeds from line of credit		11,276,862
Repayments of line of credit		(11,276,862)
Repayments of notes payable, net	(430,444)	(464,167)
Contingent consideration payments	(182,664)	(150,250)
Other financing activities	(50,000)	(111,195)
Net cash provided by financing activities	1,422,201	17,656,537
EFFECT OF EXCHANGE RATE CHANGES ON CASH	639,622	(730,511)
NET INCREASE IN CASH	5,521,651	10,110,251
CASH - beginning of the period	14,472,483	4,362,232
CASH - end of the period	19,994,134	14,472,483	$ 14,472,483
SUPPLEMENTAL NONCASH INVESTING AND FINANCING ACTIVITIES:
Vehicle financing obtained	24,909	90,284
Dividends declared, not paid	1,745,791	1,468,724
Purchase of prepaid insurance through assumption of note	301,359	271,248
Warrants issued		101,989
SUPPLEMENTAL INFORMATION - Cash paid during the period for:
Income taxes	119,265	42,057
Interest	$ 67,273	$ 64,669

Organization and Business

Organization and Business	12 Months Ended
	Dec. 31, 2019
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Business	1. Organization and Business MTBC, Inc., (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, comprehensive practice management services, 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 client support teams throughout the U.S., in Pakistan and in 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 of 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 May 2018, MTBC formed MTBC Health, Inc. (“MHI”) and MTBC Practice Management, Corp. (“MPM”), each a Delaware corporation in connection MTBC’s acquisition of substantially all of the revenue cycle management, practice management and group purchasing organization assets of Orion Healthcorp, Inc. and 13 of its affiliates (together, “Orion”). 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. The Company’s previous subsidiary in Poland was liquated in 2018. The operations in the Indian subsidiary have been terminated and the subsidiary is being liquidated. In April 2019, MTBC formed MTBC-Med, Inc. (“MED”), a Delaware corporation in connection with MTBC’s acquisition of substantially all of the revenue cycle management assets of Etransmedia Technology, Inc. (“ETM”). (See Note 3).

Significant Accounting Policies

Significant Accounting Policies	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Significant Accounting Policies	2. Significant Accounting Policies Principles of Consolidation Segment Reporting Use of Estimates Revenue Recognition Revenue from Contracts with Customers We derive revenue from seven primary sources: (1) revenue cycle management services, (2) professional services, (3) ancillary services, (4) group purchasing services, (5) printing and mailing services, (6) clearinghouse and EDI (electronic data interchange) services and (7) practice management services. All of our revenue arrangements are based on contracts with customers. Most of our contracts with customers contain single performance obligations, although certain contracts do contain multiple performance obligations where we perform more than one service for the same customer. We account for individual performance obligations separately if they are distinct within the context of the contract. For contracts where we provide multiple services such as where we perform multiple ancillary services, each service represents its own performance obligation. Selling or transaction prices are based on the contractual price for the service. A five-step approach is applied in the recognition of revenue under ASC 606: (1) identify the contract with a customer, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when we satisfy a performance obligation. Although we believe that our approach to estimates and judgments is reasonable, actual results could differ, and we may be exposed to increases or decreases in revenue that could be material. Our estimates of variable consideration may prove to be inaccurate, in which case we may have understated or overstated the revenue recognized in a reporting period. The amount of variable consideration recognized to date that remains subject to estimation is included within the contract asset within the consolidated balance sheet. Payment of invoices is due as specified in the underlying customer agreement, typically 30 days from the invoice date, which occurs on the date of transfer of control of the services to the customer. Since payment terms are less than a year, we have elected the practical expedient and do not assess whether a customer contract has a significant financing component. The Company’s revenue arrangements generally do not include a general right of refund for services provided (See Note 9, Revenue for additional information). Direct Operating Costs Selling and Marketing Expenses Research and Development Expenses Internal-Use Software Costs Accounts Receivable The movement in the allowance for doubtful accounts for the years ended December 31, 2019 and 2018 was as follows: December 31, 2019 December 31, 2018 Beginning balance $ 189,000 $ 185,000 Provision 118,000 724,000 Recoveries 316,000 - Write-offs (367,000 ) (720,000 ) Ending balance $ 256,000 $ 189,000 Inventory Property and Equipment Intangible Assets Evaluation of Long-Lived Assets There was no impairment of internal-use software costs, intangible assets or property and equipment during the years ended December 31, 2019 and 2018, other than the impairment recorded on one right-of-use (“ROU”) asset of approximately $170,000 for the year ended December 31, 2019. Goodwill st Treasury Stock Stock-Based Compensation Business Combinations Business Combinations Acquisition costs are expensed as incurred. During the years ended December 31, 2019 and 2018, the Company incurred approximately $125,000 and $245,000 of professional fees related to the acquisitions discussed in Note 3, which are included in general and administrative expenses in the consolidated statements of operations. Acquisition costs for the CareCloud acquisition discussed in Note 20 were approximately $129,000 for the year ended December 31, 2019 and are included in general and administrative expenses. Income Taxes The Company records net deferred tax assets to the extent that these assets will more likely than not be realized. All available positive and negative evidence is considered in making such a determination, including future reversals of existing taxable temporary differences, projected future taxable income, tax planning strategies, and results of recent operations. A valuation allowance would be recorded to reduce deferred income tax assets when it is determined that it is more likely than not that the Company would not be able to realize its deferred income tax assets in the future in excess of their net recorded amount. The Company records uncertain tax positions on the basis of a two-step process whereby (1) the Company determines whether it is more likely than not that the tax positions will be sustained based on the technical merits of the position and (2) for those tax positions that meet the more-likely-than-not recognition threshold, the Company recognizes the largest amount of tax benefit that is greater than 50 percent likely to be realized upon ultimate settlement with the related tax authority. At December 31, 2019 and 2018, the Company did not have any uncertain tax positions that required recognition. Interest and penalties related to uncertain tax positions are recognized in income tax expense. For the years ended December 31, 2019 and 2018, the Company did not recognize any penalties or interest related to unrecognized tax benefits in its consolidated financial statements. Dividends Deferred Rent Deferred Revenue Fair Value Measurements Fair Value Measurement Level 1 — Inputs are unadjusted quoted market prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date. Level 2 — Inputs are directly or indirectly observable, which include quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, inputs other than quoted prices that are observable for the asset or liability and inputs that are derived principally from or corroborated by observable market data by correlation or other means. Level 3 — Inputs are unobservable inputs that are used to measure fair value to the extent observable inputs are not available. The Company’s contingent consideration is a Level 3 liability and is measured at fair value at the end of each reporting period. The Company has certain financial instruments that are not measured at fair value on a recurring basis. These financial instruments are subject to fair value adjustments only in certain circumstances and include cash, accounts receivable, accounts payable and accrued expenses, borrowings under term loans and line of credit, and notes payable. Due to the short term nature of these financial instruments and that the borrowings, with the exception of the payable to the managed practices (see Note 8) bear interest at prevailing market rates, the carrying value approximates the fair value. Foreign Currency Translation Stock Offering Costs — Restructuring and Impairment Charges — Debt Acquisition Costs — Recent Accounting Pronouncements In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses: Measurement of Credit Losses on Financial Instruments. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842). We adopted the standard on January 1, 2019 using the optional transition adjustment method. As part of the adoption of ASC 842, we performed an assessment of the impact that the new lease recognition standard has on the consolidated financial statements. All of our leases, which consist of facility and equipment leases, have been classified as operating leases. The Company does not have any financing leases. We adopted the requirements of the new standard without restating the prior periods. There was no impact to the accumulated deficit as of the date of adoption. For leases in place at the transition date, we adopted the package of practical expedients that allows us to not reassess: (1) whether any expired or existing contracts are or contain leases, (2) lease classification for any expired or existing leases and (3) initial direct costs for any expired or existing leases. We have also adopted the practical expedients that allow us to treat the lease and non-lease components of our leases as a single component for our facility leases. We elected the short-term lease recognition exemption for all leases that qualify. As such, for those leases that qualify, we did not recognize ROU asset or lease liabilities as part of the transition adjustment. As of January 1, 2019, the impact on the consolidated assets was approximately $4.2 million and the impact on the consolidated liabilities was approximately $4.4 million. The adoption of ASC 842 did not have a material effect on the Company’s results of operations, stockholders’ equity, or statement of cash flows. 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. In June 2018, the FASB issued ASU 2018-07, Improvements to Nonemployee Share-Based Payment Accounting In December 2019, the FASB issued ASU 2019-12, Simplifying the Accounting for Income Taxes

Acquisitions

Acquisitions	12 Months Ended
	Dec. 31, 2019
Business Combinations [Abstract]
Acquisitions	3. ACQUISITIONS 2019 Acquisition On April 3, 2019, the Company executed an asset purchase agreement (“APA”) to acquire substantially all of the assets of ETM. The purchase price was $1.6 million and the assumption of certain liabilities, excluding acquisition-related costs of approximately $125,000. Per the APA, the acquisition had an effective date of April 1, 2019. The acquisition has been accounted for as a business combination. The ETM acquisition added additional clients to the Company’s customer base and, similar to previous acquisitions, broadened the Company’s presence in the healthcare information technology industry through geographic expansion of its customer base and by increasing available customer relationship resources and specialized trained staff. The purchase price allocation for ETM was performed by the Company and is summarized as follows: Customer relationships $ 856,000 Accounts receivable 547,377 Contract asset 139,169 Operating lease right-of-use assets 1,224,480 Property and equipment 91,277 Goodwill 39,901 Operating lease liabilities (1,224,480 ) Accrued expenses (73,724 ) Total $ 1,600,000 The acquired accounts receivable are recorded at fair value which represents amounts that have subsequently been paid or are expected to be paid by clients. The fair value of customer relationships was based on the estimated discounted cash flows generated by these intangibles. The goodwill from this acquisition is deductible ratably for income tax purposes over fifteen years and represents the Company’s ability to have an expanded local presence in additional markets and operational synergies that we expect to achieve that would not be available to other market participants. The weighted-average amortization period of the acquired intangible assets is approximately three years. Revenue earned beginning April 1, 2019, from the clients obtained from the ETM acquisition was approximately $5.1 million during the year ended December 31, 2019. 2018 Acquisition On May 7, 2018, the Company executed an asset purchase agreement (“Orion APA”) to acquire substantially all of the revenue cycle, practice management, and group purchasing organization assets of Orion. The purchase price was $12.6 million, excluding acquisition-related costs of approximately $245,000, which are included in general and administrative expense in the consolidated statement of operations. Per the Orion APA, the acquisition had an effective date of July 1, 2018. The acquisition has been accounted for as a business combination. The Orion acquisition added a significant number of clients to the Company’s customer base and, similar to previous acquisitions, broadened the Company’s presence in the healthcare information technology industry through geographic expansion of its customer base and by increasing available customer relationship resources and specialized trained staff. The acquisition also included Orion’s practice management and group purchasing services. The practice management services provide three pediatric medical practices with the nurses, administrative support, facilities, supplies, equipment, marketing, RCM, accounting and other non-clinical services needed to efficiently operate the practices. The group purchasing services enable medical providers to purchase various vaccines directly from selected pharmaceutical companies at a discounted price. The Company engaged a third party valuation specialist to assist the Company in valuing the assets and assumed liabilities acquired from Orion. The following table summarizes the purchase price allocation. Customer relationships $ 6,250,000 Accounts receivable 5,654,919 Contract asset 861,341 Inventory 307,278 Property and equipment 319,352 Goodwill 329,852 Accounts payable (677,872 ) Accrued expenses (444,870 ) Total $ 12,600,000 The acquired accounts receivable are recorded at fair value which represents amounts that have subsequently been paid or are expected to be paid by clients. The inventory acquired represents vaccines held at the managed practices. The fair value of customer relationships was based on the estimated discounted cash flows generated by these intangibles. The goodwill from this acquisition is deductible ratably for income tax purposes over fifteen years and represents the Company’s ability to have an expanded local presence in additional markets, operational synergies that we expect to achieve that would not be available to other market participants and the ability to offer group purchasing and practice management services. The weighted-average amortization period of the acquired intangibles is eight years. Revenue earned from the customers obtained from the Orion acquisition was approximately $29 million during the year ended December 31, 2019. In connection with some of the Company’s acquisitions, contingent consideration as of December 31, 2018 was payable in the form of cash with payment terms through 2019. Depending on the terms of the agreement, if the performance measures are not achieved, the Company may pay less than the recorded amount, and if the performance measures are exceeded, the Company may pay more than the recorded amount. The contingent consideration liability was fully settled during 2019. Pro forma financial information (Unaudited) The unaudited pro forma information below represents the consolidated results of operations as if the Orion and ETM acquisitions occurred on January 1, 2018. It includes revenue from the clients who had cancelled prior to each acquisition and costs and expenses discontinued before each acquisition. The pro forma information has been included for comparative purposes and is not indicative of results of operations of the Company would have had if the acquisitions occurred on the above date, nor is it necessarily indicative of future results. The unaudited pro forma information reflects adjustments related to (a) additional amortization of purchased intangible assets, (b) expenses are directly attributable to the acquisitions, (c) reversal of goodwill impairment, (d) adjustments for income taxes and (e) adjustments of intercompany balances. Year Ended December 31, 2019 2018 ($ in thousands except per share amounts) Total revenue $ 66,480 $ 81,876 Net loss $ (2,372 ) $ (12,387 ) Net loss attributable to common shareholders $ (8,758 ) $ (17,211 ) Net loss per common share $ (0.72 ) $ (1.47 )

Goodwill and Intangible Assets

Goodwill and Intangible Assets - Net	12 Months Ended
	Dec. 31, 2019
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 years ended December 31, 2019 and 2018: Year Ended Year Ended December 31, 2019 December 31, 2018 Beginning gross balance $ 12,593,795 $ 12,263,943 Acquisitions 39,901 329,852 Ending gross balance $ 12,633,696 $ 12,593,795 At December 31, 2019, and 2018, approximately $90,000 of goodwill was allocated to the Practice Management segment and the balance was allocated to the Healthcare IT segment. Below is a summary of intangible asset activity for the years ended December 31, 2019 and 2018: Customer Non-Compete Other Intangible Relationships Agreements Assets Total COST Balance, January 1, 2019 $ 22,741,300 $ 1,236,377 $ 1,477,059 $ 25,454,736 Capitalized software costs and other intangible assets - - 591,509 591,509 Translation loss - - (41,098 ) (41,098 ) Disposals - - - - Allocation from 2019 acquisition 856,000 - - 856,000 Balance, December 31, 2019 $ 23,597,300 $ 1,236,377 $ 2,027,470 $ 26,861,147 Useful lives 3-12 Years 3 Years 3 Years ACCUMULATED AMORTIZATION Balance, January 1, 2019 $ 16,457,878 $ 1,234,774 $ 1,128,081 $ 18,820,733 Amortization expense 1,855,634 1,601 205,954 2,063,189 Balance, December 31, 2019 18,313,512 1,236,375 1,334,035 20,883,922 Net book value $ 5,283,788 $ 2 $ 693,435 $ 5,977,225 COST Balance, January 1, 2018 $ 16,491,300 $ 1,236,377 $ 1,498,417 $ 19,226,094 Capitalized software costs and other intangible assets - - 108,552 108,552 Translation loss - - (129,910 ) (129,910 ) Allocation from 2018 acquisition 6,250,000 - - 6,250,000 Balance, December 31, 2018 $ 22,741,300 $ 1,236,377 $ 1,477,059 $ 25,454,736 Useful lives 3-12 Years 3 Years 3 Years ACCUMULATED AMORTIZATION Balance, January 1, 2018 $ 14,685,190 $ 1,227,601 $ 803,759 $ 16,716,550 Amortization expense 1,772,688 7,173 324,322 2,104,183 Balance, December 31, 2018 16,457,878 1,234,774 1,128,081 18,820,733 Net book value $ 6,283,422 $ 1,603 $ 348,978 $ 6,634,003 Other intangible assets primarily represent software costs. Amortization expense was approximately $2.1 million for both the years ended December 31, 2019 and 2018. The weighted-average amortization period is seven years. As of December 31, 2019, future amortization expense scheduled to be expensed is as follows: Year ending December 31 2020 $ 1,437,324 2021 1,292,146 2022 959,225 2023 338,530 2024 300,000 Thereafter 1,650,000 Total $ 5,977,225

Property and Equipment

Property and Equipment	12 Months Ended
	Dec. 31, 2019
Property, Plant and Equipment [Abstract]
Property and Equipment	5. Property and Equipment Property and equipment as of December 31, 2019 and 2018 consisted of the following: December 31, 2019 December 31, 2018 Computer equipment $ 2,905,892 $ 2,389,865 Office furniture and equipment 1,145,617 1,089,014 Transportation equipment 806,009 828,417 Leasehold improvements 931,955 727,519 Assets not placed in service 1,004,252 50,362 Total property and equipment 6,793,725 5,085,177 Less accumulated depreciation (3,886,209 ) (3,252,990 ) Property and equipment – net $ 2,907,516 $ 1,832,187 Depreciation expense was approximately $909,000 and $688,000 for the years ended December 31, 2019 and 2018, respectively.

Concentrations

Concentrations	12 Months Ended
	Dec. 31, 2019
Risks and Uncertainties [Abstract]
Concentrations	6. Concentrations Financial Risks Concentrations of credit risk with respect to trade accounts receivable are managed by periodic credit evaluations of customers. The Company does not require collateral for outstanding trade accounts receivable. As of December 31, 2019, two customers individually accounted for approximately 9% and 5% of accounts receivable, respectively. As of December 31, 2018, two customers individually accounted for approximately 8% and 7% of accounts receivable respectively. During both the years ended December 31, 2019 and 2018, there was one customer with sales of approximately 10% of total revenue. Geographical Risks Carrying amounts of net assets located outside the United States were approximately $1.7 million and $162,000 as of December 31, 2019 and 2018, respectively. These balances exclude intercompany receivables of approximately $7.1 million and $7.6 million as of December 31, 2019 and 2018, respectively. The following is a summary of the net assets located outside the United States as of December 31, 2019 and 2018: December 31, 2019 2018 Current assets $ 1,082,233 $ 156,265 Non-current assets 2,242,816 1,259,446 3,325,049 1,415,711 Current liabilities (1,270,015 ) (1,044,539 ) Non-current liabilities (332,276 ) (209,333 ) Net assets $ 1,722,758 $ 161,839

Net Loss Per Common Share

Net Loss Per Common Share	12 Months Ended
	Dec. 31, 2019
Earnings Per Share [Abstract]
Net Loss Per Common Share	7. NET LOss per COMMON share The following table reconciles the weighted-average shares outstanding for basic and diluted net loss per common share for the years ended December 31, 2019 and 2018: Year Ended December 31, 2019 2018 Basic and Diluted: Net loss attributable to common shareholders $ (7,257,954 ) $ (6,962,467 ) Weighted-average common shares used to compute basic and diluted loss per share 12,087,947 11,721,232 Net loss attributable to common shareholders per share - Basic and Diluted $ (0.60 ) $ (0.59 ) All unvested restricted stock units (“RSUs”), the 200,000 warrants granted to Opus Bank (“Opus”) and the 153,489 warrants granted to Silicon Valley Bank (“SVB”) 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	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Debt	8. DEBT SVB In connection with the original 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 original SVB credit agreement, these 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. As a result of the revision in the SVB credit line, which increased the credit line from $5 million to $10 million and reduced the interest rate by 25 basis points, the Company paid approximately $50,000 of fees upfront and issued an additional 28,489 warrants, with a strike price equal to $5.26, a five-year exercise window and net exercise rights. The additional warrants were valued at $3.58 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 December 31, 2019 and 2018, the Company was in compliance with all covenants. During November 2019 the Company modified its loan agreement with SVB, which adjusted the required monthly EBITDA amounts and does not require the Company to comply with financial covenants as long as there have been no borrowings on the revolving credit line for the prior six months. Vehicle Financing Notes Insurance Financing Payable to Managed Practices — Maturities of the outstanding notes payable and other obligations as of December 31, 2019 are as follows: Year ending December 31 Vehicle Insurance Financing Payable to Managed Total 2020 $ 67,129 $ 132,546 $ 84,000 $ 283,675 2021 37,410 - 26,000 63,410 2022 15,171 - - 15,171 2023 4,694 - - 4,694 Total $ 124,404 $ 132,546 $ 110,000 $ 366,950

Revenue

Revenue	12 Months Ended
	Dec. 31, 2019
Revenue from Contract with Customer [Abstract]
Revenue	9. REVENUE Introduction The Company accounts for revenue in accordance with ASC 606, Revenue from Contracts with Customers Most of our current contracts with customers contain a single performance obligation. For contracts where we provide multiple services, such as where we perform multiple ancillary services, each service represents its own performance obligation. Selling prices are based on the contractual price for the service. 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. Disaggregation of Revenue from Contracts with Customers We derive revenue from seven primary sources: revenue cycle management services, practice management services, professional services, ancillary services, group purchasing services, printing and mailing services, and clearinghouse and EDI (electronic data interchange) services. The following table represents a disaggregation of revenue for the years ended December 31, 2019 and 2018: Year Ended 2019 2018 Healthcare IT: Revenue cycle management services $ 42,919,944 $ 38,559,180 Professional services 1,769,129 1,244,894 Ancillary services 3,220,372 1,594,364 Group purchasing services 1,020,031 654,805 Printing and mailing services 1,650,069 1,344,011 Clearinghouse and EDI services 591,963 647,446 Practice Management: Practice management services 13,267,086 6,501,081 Total $ 64,438,594 $ 50,545,781 Revenue cycle management services: Revenue cycle management services are 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 typically 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 services include use of practice management software and related tools (on a software-as-a-service (“SaaS”) basis), electronic health records (on a SaaS basis), medical billing services and use of mobile health solutions. We consider the services to be one performance obligation since the promises are not distinct in the context of the contract. The performance obligation consists of a series of distinct services that are substantially the same and have the same periodic pattern of transfer to our customers. 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. Although our contracts typically 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. For the majority of our revenue cycle management contracts, the total transaction price is variable because our obligation is to process an unknown quantity of claims, as and when requested by our customers over the contract period. 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 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 variable consideration is subsequently resolved. Estimates to determine variable consideration such as payment to charge ratios, effective billing rates, and the estimated contractual payment periods are updated at each reporting date. Revenue is recognized over the performance period using the input method. Other revenue streams: MTBC also provides implementation and professional services to clearinghouse and other customers and records revenue monthly on a time and materials or a fixed rate basis. This is a separate performance obligation from the clearinghouse and recurring EDI services provided, for which the Company receives and records monthly fees. The performance obligation is satisfied over time as the implementation or professional services are rendered. Ancillary services represent services such as coding and transcription that are rendered in connection with the delivery of revenue cycle management and related medical 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 revenue cycle management 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 over time as that individual service is rendered. The Company provides group purchasing services which enable medical providers to purchase various vaccines directly from selected pharmaceutical companies at a discounted price. Currently, there are approximately 4,056 medical providers who are members of the program. Revenue is recognized as the vaccine shipments are made to the medical providers. Fees from the pharmaceutical companies are paid either quarterly or annually and the Company adjusts its revenue accrual at the time of payment. The Company makes significant judgments regarding the variable consideration which we expect to be entitled to for the group purchasing services which includes the anticipated shipments to the members enrolled in the program, anticipated volumes of purchases made by the members, and the changes in the number of members. The amounts recorded are constrained by estimates of decreases in shipments and loss of members to avoid a significant revenue reversal in the subsequent period. The only performance obligation is to provide the pharmaceutical companies with the medical providers who want to become members in order to purchase vaccines. The performance obligation is satisfied once the medical provider agrees to purchase a specific quantity of vaccines and the medical provider’s information is forwarded to the vaccine suppliers. The Company records a contract asset for revenue earned and not paid as the ultimate payment is conditioned on achieving certain volume thresholds. The Company provides printing and mailing services for both revenue cycle management customers and a non-revenue cycle management 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 service 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 medical practices and providers to medical practices who are not revenue cycle management customers. The performance obligation is satisfied once the relevant submissions are completed. For all of the above revenue streams other than group purchasing services, revenue is recognized over time, which is typically one month or less, which closely matches the point in time that the customer simultaneously receives and consumes the benefits provided by the Company. For the group purchasing services, revenue is recognized at a point in time. Each service is substantially the same and has the same periodic pattern of transfer to the customer. Each of the services provided above is considered a separate performance obligation. Practice management services: The Company also provides practice management services under long-term management service agreements to three medical practices. We provide the medical practices with the nurses, administrative support, facilities, supplies, equipment, marketing, RCM, accounting, and other non-clinical services needed to efficiently operate their practices. Revenue is recognized as the services are provided to the medical practices. Revenue recorded in the consolidated statements of operations represents the reimbursement of costs paid by the Company for the practices and the management fee earned each month for managing the practice. The management fee is based on either a fixed fee or a percentage of the net operating income. The Company assumes all financial risk for the performance of the managed medical practices. Revenue is impacted by amount of the costs incurred by the practices and their operating income. The gross billing of the practices is impacted by billing rates, changes in current procedural terminology code reimbursement and collection trends which in turn impacts the management fee that the Company is entitled to. Billing rates are reviewed at least annually and adjusted based on current insurer reimbursement practices. The performance obligation is satisfied as the management services are provided. Our contracts for practice management services have approximately an additional 20 years remaining and are only cancellable under very limited circumstances. The Company receives a management fee each month for managing the day-to-day business operations of each medical group as a fixed fee or a percentage payment of the net operating income which is included in revenue in the consolidated statements of operations. Our practice management services obligations consist of a series of distinct services that are substantially the same and have the same periodic pattern of transfer to our customers. Revenue is recognized over time, however for reporting and convenience purposes management fee is computed at each month end. Information about contract balances: As of December 31, 2019, the estimated revenue expected to be recognized in the future related to the remaining revenue cycle management performance obligations outstanding was approximately $2.0 million. We expect to recognize substantially all of the revenue for the remaining performance obligations over the next three months. Approximately $374,000 of the contract asset represents revenue earned, not paid, from the group purchasing services. 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 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 revenue cycle management 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 also includes the revenue accrued, not received, for the group purchasing services. Changes in the contract asset are recorded as adjustments to net revenue. The changes primarily result from providing services to revenue cycle management customers that result in additional consideration and are offset by our right to payment for services becoming unconditional and changes in the revenue accrued for the group purchasing services. The contract asset for our group purchasing services is reduced when we receive payments from vaccine manufacturers and is increased for revenue earned, not received. The opening and closing balances of the Company’s accounts receivable, contract asset and deferred revenue are as follows: Accounts Receivable, Contract Deferred Deferred Revenue Balance as of January 1, 2018 $ 3,879,463 $ 1,342,692 $ 62,104 $ 28,615 Orion acquisition 5,654,919 861,341 - - (Decrease) increase, net (2,202,908 ) 404,598 (36,749 ) (9,666 ) Balance as of December 31, 2018 $ 7,331,474 $ 2,608,631 $ 25,355 $ 18,949 Balance as of January 1, 2019 $ 7,331,474 $ 2,608,631 $ 25,355 $ 18,949 ETM acquisition - 139,169 - - Decrease, net (336,131 ) (362,466 ) (5,078 ) (204 ) Balance as of December 31, 2019 $ 6,995,343 $ 2,385,334 $ 20,277 $ 18,745 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. 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 $29,000 and $93,000 at December 31, 2019 and 2018, respectively, and are included in the Other Assets lines in the consolidated balance sheets.

Shareholders' Equity

Shareholders' Equity	12 Months Ended
	Dec. 31, 2019
Equity [Abstract]
Shareholders' Equity	10. SHAREHOLDERS’ EQUITY Treasury stock The Board of Directors of the Company previously approved stock repurchase programs. The last program expired January 25, 2017. As a result of these stock repurchases, the Company has 740,799 shares held as treasury stock at an aggregate cost of $662,000. Common stock There were no common stock offerings during 2019 and 2018. Holders of our common stock are entitled to one vote for each share held on all matters properly submitted to a vote of shareholders on which holders of common stock are entitled to vote. Holders of common stocks are entitled to receive dividends only at times and amounts as determined by the Board of Directors. The common stock is not entitled to pre-emptive rights, and is not subject to conversion, redemption or sinking fund provisions. Preferred Stock During the year ended December 31, 2019, the Company completed a public offering of 373,000 shares of its Preferred Stock at the prevailing market price, raising net proceeds of approximately $9.6 million after underwriting commissions and other directly attributable expenses. During the year ended December 31, 2018, the Company completed two public offerings of approximately one million shares of its Preferred Stock at $25.00 per share, raising net proceeds of approximately $22.8 million after underwriting commissions and expenses. Dividends on the Preferred Stock of $2.75 annually per share are cumulative from the date of issue and are payable each month when, as and if declared by the Company’s Board of Directors. As of December 31, 2019, the Board of Directors has declared monthly dividends on the Preferred Stock payable through February 2020. Commencing on or after November 4, 2020, the Company may redeem, at its option, the Preferred Stock, in whole or in part, at a cash redemption price of $25.00 per share, plus all accrued and unpaid dividends to, but not including, the redemption date. The Preferred Stock has no stated maturity, is not subject to any sinking fund or other mandatory redemption, and is not convertible into or exchangeable for any of the Company’s other securities. Holders of the Preferred Stock have no voting rights except for limited voting rights if dividends payable on the Preferred Stock are in arrears for eighteen or more consecutive or non-consecutive monthly dividend periods. If the Company were to liquidate, dissolve or wind up, the holders of the Preferred Stock will have the right to receive $25.00 per share, plus any accumulated and unpaid dividends to, but not including, the date of payment, before any payment is made to the holders of the common stock. The Preferred Stock is listed on the Nasdaq Global Market under the trading symbol “MTBCP.” Warrants The Company has issued 2,353,489 warrants for its common stock, of which 353,489 remained outstanding at December 31, 2018. The 2,000,000 warrants previously issued at a $5 exercise price expired in May 2018. The outstanding warrants consist of 100,000 warrants at a $5 exercise price which will expire in September, 2022, 125,000 warrants at a $3.92 exercise price which will expire in October 2022, 100,000 warrants at a $5 exercise price which will expire in July 2023 and 28,489 warrants at a $5.26 exercise price which will expire in September 2023.

Commitments and Contingencies

Commitments and Contingencies	12 Months Ended
	Dec. 31, 2019
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	11. COMMITMENTS AND CONTINGENCIES Legal Proceedings On April 23, 2019, the Appellate Division reversed the Chancery Court’s ruling that MTBC is required to participate in the Arbitration and remanded the case for further proceedings before the Chancery Court on that issue. The Appellate Division upheld the Chancery Court’s ruling that MAC was required to participate in the Arbitration. The parties have completed discovery in the remanded matter, and both MTBC and RPRWC filed cross-motions for summary judgement in their favor. On February 6, 2020, the Chancery Court denied RPRWC’s motion for summary judgment and granted MTBC’s cross-motion for summary judgment. The Chancery Court held that MTBC cannot be compelled to participate in the Arbitration. RPRWC has informed MTBC that it does not intend to appeal the Chancery Court’s ruling and that it intends to move forward solely against MAC in the Arbitration. RPRWC seeks compensatory damages of $6.6 million, plus costs, for MPMA’s alleged breach of the billing services agreement. RPRWC’s breach of contract and compensatory damages claims have not been the subject of the ongoing court proceedings, which have focused solely on whether RPRWC can compel MTBC and MAC to arbitrate its claim. Thus, RPRWC has not yet provided MAC with information sufficient to enable it to estimate a range of possible losses that may arise from the Arbitration. MAC intends to vigorously defend against RPRWC’s claims. If RPRWC is successful in the Arbitration, MAC anticipates the award would be substantially less than the amount claimed. 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

Leases	12 Months Ended
	Dec. 31, 2019
Leases [Abstract]
Leases	12. Leases We determine if an arrangement is a lease at inception. Operating leases are included in operating lease ROU assets, current operating lease liability and non-current operating lease liability in our consolidated balance sheet as of December 31, 2019. The Company does not have any finance leases. ROU assets represent our right to use an underlying asset for the lease term and lease liabilities represent our obligation to make lease payments arising from the lease. ROU assets and liabilities are recognized at the lease commencement date based on the estimated present value of lease payments over the lease term. We use our estimated incremental borrowing rates, which are derived from information available at the lease commencement date, in determining the present value of lease payments. For leases in existence at the adoption of ASC 842, we used the incremental borrowing rate as of January 1, 2019. We give consideration to our bank financing arrangements, geographical location and collateralization of assets when calculating our incremental borrowing rates. Our lease terms include options to extend the lease when it is reasonably certain that we will exercise that option. Leases with a term of less than 12 months are not recorded in the consolidated balance sheet. Our lease agreements do not contain any residual value guarantees. For real estate leases, we account for the lease and non-lease components as a single lease component. Some leases include escalation clauses and termination options that are factored in the determination of the lease payments when appropriate. If a lease is modified after the effective date, the operating lease ROU asset and liability is re-measured using the current incremental borrowing rate. During the year ended December 31, 2019, a lease impairment of approximately $170,000 was recorded since the Company is no longer using one of its leased facilities and is currently in the process of subleasing the space. Restructuring charges of approximately $49,000 were recorded in the year ended December 31, 2019 which represent the remaining lease costs for another leased facility that was closed and the employees were transferred to another Company facility. We lease all of our facilities and some equipment. Lease expense is included in direct operating costs and general and administrative expenses in the consolidated statements of operations based on the nature of the expense. As of December 31, 2019, we had 29 leased properties, five in Practice Management and 24 in Healthcare IT, with remaining terms ranging from less than one year to four years. Our lease terms are determined taking into account lease renewal options, the Company’s anticipated operating plans and leases that are on a month-to-month basis. We also have some related party leases – see Note 13. The components of lease expense were as follows: Year Ended Operating lease cost $ 2,184,880 Short-term lease cost 229,263 Variable lease cost 41,714 Total- net lease cost $ 2,455,857 Short-term lease cost represents leases that were not capitalized as the lease term as of the later of January 1, 2019 or the beginning of the lease was less than 12 months. Variable lease costs include utilities, real estate taxes and common area maintenance costs. Supplemental balance sheet information related to leases was as follows: December 31, 2019 Operating leases: Operating lease ROU assets, net $ 3,526,315 Current operating lease liabilities $ 1,688,772 Non-current operating lease liabilities 2,040,772 Total operating lease liabilities $ 3,729,544 Operating leases: ROU assets $ 5,467,749 Asset lease expense (1,888,443 ) Foreign exchange loss (52,991 ) ROU assets, net $ 3,526,315 Weighted average remaining lease term (in years): Operating leases 2.46 Weighted average discount rate: Operating leases 7.05 % Supplemental cash flow and other information related to leases was as follows: Year Ended Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 2,332,167 ROU assets obtained in exchange for lease liabilities: Operating leases, net of restructuring, impairment and terminations $ 1,221,989 Maturities of lease liabilities are as follows: Operating leases - Year ended December 31, 2020 $ 1,887,651 2021 1,382,639 2022 624,528 2023 154,492 2024 4,694 Total lease payments 4,054,004 Less: imputed interest (324,460 ) Total lease obligations 3,729,544 Less: current obligations 1,688,772 Long-term lease obligations $ 2,040,772 As of December 31, 2019, we have one operating lease commitment with a six year term that commences on January 1, 2020 aggregating approximately $1.0 million. For comparative periods prior to the adoption of the new accounting guidance on January 1, 2019, we have retained the following disclosures as previously reported. Future minimum lease payments under non-cancelable operating leases as of December 31, 2018 were as follows: Operating leases 2019 $ 932,068 2020 715,059 2021 510,927 2022 412,585 2023 91,797 Total $ 2,662,436

Related Parties

Related Parties	12 Months Ended
	Dec. 31, 2019
Related Party Transactions [Abstract]
Related Parties	13. 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 $21,000 for the year ended December 31, 2019 and approximately $20,000 for the year ended December 31, 2018. As of December 31, 2019 and 2018, the accounts receivable balance due from this customer was approximately $2,000 and $1,600, respectively and is included in accounts receivable in the consolidated balance sheets. 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 expense of approximately $137,000 and $128,000, for the years ended December 31, 2019 and 2018, respectively. As of December 31, 2019 and 2018, the Company had liabilities outstanding to KAI of approximately $1,000 and $11,000, which are included in accrued liability to related party in the consolidated balance sheets. The original aircraft lease expired on March 31, 2019 and was not included in the ROU asset at January 1, 2019. A lease for a different aircraft at the same lease rate was entered into as of April 1, 2019 and has been included in the ROU asset and operating lease liability at December 31, 2019. The Company leases its corporate offices in New Jersey, its temporary housing for its foreign visitors, an office/storage facility and its backup operations center in Bagh, Pakistan, from the Executive Chairman. The related party rent expense for the years ended December 31, 2019 and 2018 was approximately $192,000 and $187,000, respectively, and is included in direct operating costs and general and administrative expense in the consolidated statements of operations. During the year ended December 31, 2019, the Company spent approximately $330,000 to upgrade two of the leased facilities. Current assets-related party in the consolidated balance sheets includes security deposits and prepaid rent related to the leases of the Company’s corporate offices in the amount of $13,000 and $25,000 as December 31, 2019 and 2018, respectively. Included in the ROU asset at December 31, 2019 is approximately $566,000 applicable to the related party leases. Included in the current and non-current operating lease liability at December 31, 2019 is approximately $275,000 and $298,000, respectively, applicable to the related party leases.

Employee Benefit Plans

Employee Benefit Plans	12 Months Ended
	Dec. 31, 2019
Retirement Benefits [Abstract]
Employee Benefit Plans	14. Employee Benefit PlanS The Company has a qualified 401(k) plan covering all U.S. employees of MTBC, Inc. and MAC who have completed one month of service. The plan provides for matching contributions by the Company equal to 100% of the first 3% of qualified compensation, plus 50% of the next 2%. The Company also maintain a qualified 401(k) plan for MHI, MPM and MED employees who have completed one month of service. There is a discretionary match for MHI and MED employees equal to 50% of the first 3% of qualified compensation. There is no match for MPM employees. Employer contributions to the plans for the years ended December 31, 2019 and 2018 were approximately $255,000 and $161,000, respectively. Additionally, the Company has a defined contribution retirement plan covering all employees located in Pakistan who have completed three months of service. The plan provides for monthly contributions by the Company which are the lower of 10% of qualified employees’ basic monthly compensation or 2,500 Pakistani rupees. The Company’s contributions for the years ended December 31, 2019 and 2018 were approximately $245,000 and $110,000, respectively. The Company maintains a defined contribution retirement plan covering all employees in Sri Lanka. The employee and employer contribute 8% and 12%, respectively, of the employee’s gross salary. The Company’s contribution for the year ended December 31, 2019 and 2018 were approximately $40,000 and $56,000, respectively. The contributions are required to be deposited with the Employees’ Provident Fund Organization, a government owned entity.

Stock-Based Compensation

Stock-Based Compensation	12 Months Ended
	Dec. 31, 2019
Share-based Payment Arrangement [Abstract]
Stock-Based Compensation	15. STOCK-BASED COMPENSATION In April 2014, the Company adopted the Medical Transcription Billing, Corp. 2014 Equity Incentive Plan (the “2014 Plan”), reserving a total of 1,351,000 shares of common stock for grants to employees, officers, directors and consultants. During 2017, the 2014 Plan was amended whereby an additional 1,500,000 shares of common stock and 100,000 shares of Preferred Stock were added to the plan for future issuance. During 2018, an additional 200,000 shares of Preferred Stock was added to the plan for future issuance. The 2014 Plan was amended and restated on April 14, 2017 (the “Amended and Restated Equity Incentive Plan”). As of December 31, 2019, 401,738 shares of common stock and 133,654 shares of Preferred Stock are available for grant. 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 During the third quarter of 2018, 68,000 RSUs of common stock were granted over two years equally to the four outside members of the Board of Directors with 25% of the shares vesting every six months. Also, during 2018, a total of 558,000 RSUs of common stock were granted to certain Company executive officers and employees which vest over the next three years, at six-month intervals. A total of 81,200 cash settled common stock RSUs were granted to employees in Pakistan and Sri Lanka. During 2019, 108,000 RSUs of common stock were granted to employees and independent contractors to vest at different dates during the year 2020. In addition, 72,000 RSUs of common stock were granted over two years equally to the four outside members of the Board of Directors with 25% of the shares vesting every six months. The following table summarizes the RSU and restricted stock transactions related to the common and Preferred Stock under the Amended and Restated Incentive Plan for the years ended December 31, 2019 and 2018: Common Stock Preferred Stock Outstanding and unvested shares at January 1, 2018 605,969 39,800 Granted 707,200 44,800 Vested (340,066 ) (39,800 ) Forfeited (43,756 ) - Outstanding and unvested shares at December 31, 2018 929,347 44,800 Granted 180,000 48,746 Vested (624,315 ) (49,546 ) Forfeited (33,948 ) - Outstanding and unvested shares at December 31, 2019 451,084 44,000 As of December 31, 2019, and 2018, there was approximately $2.1 million and $2.5 million, respectively, of total unrecognized compensation cost related to the common stock RSUs classified as equity that will be expensed through 2021. There was no unrecognized compensation cost related to the Preferred Stock RSUs. Of the total outstanding and unvested common stock RSUs at December 31, 2019, 421,751 RSUs are classified as equity and 29,333 RSUs are classified as a liability. All of the Preferred Stock RSUs are classified as equity. The following table summarizes the share activity during the years ended December 31, 2019 and 2018 and the amount of common and Preferred Shares available for grant at December 31, 2019: Common Stock Preferred Stock Shares available for grant at January 1, 2018 1,211,234 27,200 Additional shares available for grant - 200,000 RSUs granted (707,200 ) (44,800 ) RSUs forfeited 43,756 - Shares available for grant at December 31, 2018 547,790 182,400 RSUs granted (180,000 ) (48,746 ) RSUs forfeited 33,948 - Shares available for grant at December 31, 2019 401,738 133,654 The liability for the cash-settled awards was approximately $741,000 and $118,000 at December 31, 2019 and 2018, respectively, and is included in accrued compensation in the consolidated balance sheets. During the years ended December 31, 2019 and 2018, approximately $184,000 and $39,000, respectively, was paid in connection with the cash-settled awards. Preferred Stock In 2019 and 2018, the Compensation Committee approved executive bonuses to be paid in 44,000 and 40,000 shares respectively of Preferred Stock, with the final number of shares and the amount based on specified performance criteria being achieved during 2019 and 2018. In 2019, 4,746 shares of Preferred Stock were granted as performance bonuses and in lieu of sales commissions. In 2018, an additional Preferred Stock award of 4,800 shares was granted as a performance bonus to one employee. Stock-based compensation expense recorded during 2019 and 2018 for these awards was approximately $1.3 million and $1.2 million respectively, based on the fair value of the Preferred Shares on the grant date. During January 2020 and February 2019, the Compensation Committee determined that the financial objectives were attained and all of the shares were issued including the performance bonus shares. 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. The weighted average grant date fair value of the common stock price in connection with the RSUs classified as equity was $4.87 and $4.53 for the years ended December 31, 2019 and 2018, respectively. The weighted average grant date fair value of the Preferred Stock in connection with the RSUs was $26.77 and $25.00 for the years ended December 31, 2019 and 2018, respectively. The following table summarizes the components of stock-based compensation expense for the years ended December 31, 2019 and 2018: Stock-based compensation included in the December 31, 2019 2018 Direct operating costs $ 196,956 $ 88,195 General and administrative 2,735,178 2,352,850 Research and development 33,029 14,506 Selling and marketing 250,498 8,048 Total stock-based compensation expense $ 3,215,661 $ 2,463,599

Income Taxes

Income Taxes	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Income Taxes	16. INCOME TAXES For the years ended December 31, 2019 and 2018, the Company estimated its income tax provision based upon the annual pre-tax loss. Although the Company is forecasting a return to profitability, it incurred cumulative losses which make 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 December 31, 2019 and December 31, 2018, with the exception of a net deferred tax liability relating to the amortization of intangibles for tax purposes. As of January 1, 2018, all adjusted foreign income amounts became taxable due to a change in U.S. tax law under the recent tax reform legislation discussed below. For state tax purposes, the Company’s foreign earnings may be taxable depending on each individual state’s legislative stance on the recent tax reform legislation. The activity in the deferred tax valuation allowance was as follows for the years ended December 31, 2019 and 2018: Year ended December 31, 2019 2018 Beginning balance $ 7,176,391 $ 6,620,464 Provision 371,468 400,158 Adjustments/true-ups (393,349 ) 155,769 Ending balance $ 7,154,510 $ 7,176,391 The adjustments/true-ups for 2019 primarily represent the deferred tax effect of the Company’s adoption of ASC 606. The adjustments/true-ups for 2018 primarily represent the use of federal net operating losses to offset the Transition Tax as defined below. Accordingly, additional valuation allowances needed to be provided. Since a full valuation allowance is recorded on the Company’s deferred tax assets, there was no effect on the Company’s consolidated balance sheet. The loss before tax for financial reporting purposes during the years ended December 31, 2019 and 2018 consisted of the following: Year ended December 31, 2019 2018 United States $ (1,154,831 ) $ (4,111,539 ) Foreign 475,811 1,815,674 Total $ (679,020 ) $ (2,295,865 ) The provision (benefit) for income taxes for the years ended December 31, 2019 and 2018 consisted of the following: Year ended December 31, 2019 2018 Current: Federal $ - $ - State 102,677 49,000 Foreign 9,937 1,341 112,614 50,341 Deferred: Federal 27,689 (225,347 ) State 52,477 17,621 80,166 (207,726 ) Total income tax provision (benefit) $ 192,780 $ (157,385 ) The components of the Company’s deferred income taxes as of December 31, 2019 and 2018 are as follows: December 31, 2019 December 31, 2018 Deferred tax assets: Allowance for doubtful accounts $ 65,529 $ 46,492 Deferred revenue 4,807 4,664 Deferred rent - 4,275 Property and intangible assets 2,301,987 2,336,221 State net operating loss (“NOL”) carryforwards 910,274 636,578 Federal net operating loss (“NOL”) carryforwards 4,146,274 3,789,618 Section 163(j) interest limitation 13,499 51,319 Cumulative translation adjustment 216,255 349,834 Stock based compensation 118,377 335,785 ASC 606 - Section 481(A) adjustment (185,162 ) - ASC 842-ROU asset (790,446 ) - ASC 842 - Lease liability 799,376 - Other 18,238 (24,654 ) Valuation allowance (7,154,510 ) (7,176,391 ) Total deferred tax assets 464,498 353,741 Deferred tax liabilities: Goodwill amortization (709,010 ) (518,087 ) Net deferred tax liability $ (244,512 ) $ (164,346 ) Deferred income tax balances reflect the effects of temporary differences between the carrying amounts of assets and liabilities and their tax bases, as well as from net operating loss carryforwards. Deferred income tax assets represent amounts available to reduce income taxes payable on taxable income in future years. The Company has recorded goodwill as a result of its acquisitions. Goodwill is generally not amortized for financial reporting purposes. For tax purposes, goodwill is tax deductible and amortized over 15 years. As such, deferred income tax expense and a deferred tax liability arise as a result of the tax-deductibility of this indefinitely lived asset (also known as a naked credit). The resulting deferred tax liability, which is expected to continue to increase over the amortization period, will have an indefinite life. As a result of the Company incurring a tax loss for 2018 which has an indefinite life under the recent tax reform legislation, the federal deferred tax liability resulting from the amortization of goodwill was offset against the 2019 federal operating net loss, to the extent allowable. This resulted in a deferred tax benefit of approximately $208,000 in 2018. The remaining deferred tax liability could remain on the Company’s consolidated balance sheet indefinitely unless there is an impairment of goodwill (for financial reporting purposes) or a portion of the business is sold. Due to the fact that the aforementioned deferred tax liability could have an indefinite life, it is not netted against the Company’s deferred tax assets when determining the required valuation allowance in accordance with ASC 740 guidelines. Doing so would result in the understatement of the valuation allowance and related deferred income tax expense. A reconciliation of the federal statutory income tax rate (21%) for 2019 and 2018 to the Company’s effective income tax rate (determined in dollars) for the years ended December 31, 2019 and 2018 is as follows: Year ended December 31, 2019 2018 Federal benefit at statutory rate $ (142,594 ) $ (482,132 ) Increase (decrease) in income taxes resulting from: State tax expense, net of federal benefit 142,079 29,646 Non-deductible items 24,883 15,332 Impact of foreign operations 31,408 (525,583 ) Subpart F GILTI inclusion 69,862 360,742 Deferred true-up 332,792 (142,869 ) Valuation allowance (304,009 ) 555,927 Additional tax goodwill/contingent consideration 38,359 31,553 Total income tax provision (benefit) $ 192,780 $ (157,385 ) At December 31, 2019 and 2018, the Company did not record any uncertain tax positions based on the technical merits. Therefore, a tabular roll forward was excluded and there has been no accrued interest and penalties. The Company is subject to taxation in the United States, various states, Pakistan and Sri Lanka. As of December 31, 2019, tax years 2016 through 2018 remain open to examination in the United States by major taxing jurisdictions in which the Company is subject to tax. The Pakistan Federal Board of Revenue issued a tax holiday, which precludes the Pakistan subsidiary from being subject to income taxes through June 2025. It is the Company’s policy that any assessed penalties and interest on uncertain tax positions would be charged to income tax expense. The Pakistan tax holiday does not have a significant impact on the Company’s effective tax rate as all of its earnings in Pakistan have been fully included in the U.S. federal tax rate of 21% for 2019 and 2018. The Pakistan statutory corporate tax rate is 29% before consideration of the aforementioned tax holiday. The Company has a federal NOL carry forward of approximately $19.8 million of which approximately $15.8 million will expire between 2034 and 2037 and $4.0 million has an indefinite life. The Company has state NOL carry forwards which mainly consists of approximately $38.5 million, of which $17.9 million relates to the State of New Jersey. These NOLs expire between 2034 to 2039. The Company has a full valuation allowance on its deferred tax assets in the U.S. which results in there being no U.S. deferred tax assets or liabilities recorded on the consolidated balances sheet. Other than the deferred tax liability related to the amortization of goodwill.

Other (Expense) Income - Net

Other (Expense) Income - Net	12 Months Ended
	Dec. 31, 2019
Other Income and Expenses [Abstract]
Other (Expense) Income - Net	17. OTHER (EXPENSE) INCOME – NET Other (expense) income - net for the years ended December 31, 2019 and 2018 consisted of the following: Year Ended December 31, 2019 2018 Foreign exchange (loss) gain $ (827,121 ) $ 434,806 Other income 201,446 59,526 Other (expense) income - net $ (625,675 ) $ 494,332 Foreign currency transaction gains and losses primarily result from transactions in foreign currencies other than the functional currency. These transaction gains and losses are recorded in the consolidated statements of operations related to the recurring measurement and settlement of such transactions.

Segment Reporting

Segment Reporting	12 Months Ended
	Dec. 31, 2019
Segment Reporting [Abstract]
Segment Reporting	18. segment reporting Both our Chief Executive Officer and Executive Chairman serve as the CODM, organize the Company, manage resource allocations and measure performance among two operating and reportable segments: (i) Healthcare IT and (ii) Practice Management. The Healthcare IT segment includes revenue cycle management and other services. The Practice management segment includes the management of three medical practices. Each segment is considered a reporting unit. The CODM evaluates financial performance of the business units on the basis of revenue and direct operating costs excluding unallocated amounts, which are mainly corporate overhead costs. Our CODM does not evaluate operating segments using asset or liability information. The accounting policies of the segments are the same as those disclosed in the summary of significant accounting policies. The following tables present revenues, operating expenses and operating income (loss) by reportable segment for the years ended December 31, 2019 and 2018: Year Ended December 31, 2019 Healthcare IT Practice Management Unallocated Corporate Expenses Total Net revenue $ 51,171,508 $ 13,267,086 $ - $ 64,438,594 Operating expenses: Direct operating costs 30,798,404 10,387,620 - 41,186,024 Selling and marketing 1,487,196 34,619 - 1,521,815 General and administrative 11,124,271 2,066,522 4,721,004 17,911,797 Research and development 870,780 - - 870,780 Change in contingent consideration (343,768 ) - - (343,768 ) Depreciation and amortization 2,689,240 316,366 - 3,005,606 Restructuring and impairment charges 219,013 - - 219,013 Total operating expenses 46,845,136 12,805,127 4,721,004 64,371,267 Operating income (loss) $ 4,326,372 $ 461,959 $ (4,721,004 ) $ 67,327 Year Ended December 31, 2018 Healthcare IT Practice Management Unallocated Total Net revenue $ 44,044,700 $ 6,501,081 $ - $ 50,545,781 Operating expenses: Direct operating costs 26,289,770 4,962,765 - 31,252,535 Selling and marketing 1,593,052 18,930 - 1,611,982 General and administrative 9,834,749 1,164,505 5,265,219 16,264,473 Research and development 1,029,510 - - 1,029,510 Change in contingent consideration 73,271 - - 73,271 Depreciation and amortization 2,700,577 153,250 - 2,853,827 Total operating expenses 41,520,929 6,299,450 5,265,219 53,085,598 Operating income (loss) $ 2,523,771 $ 201,631 $ (5,265,219 ) $ (2,539,817 )

Fair Value of Financial Instrum

Fair Value of Financial Instruments	12 Months Ended
	Dec. 31, 2019
Fair Value Disclosures [Abstract]
Fair Value of Financial Instruments	19. FAIR VALUE OF FINANCIAL INSTRUMENTS As of December 31, 2019, and December 31, 2018, the carrying amounts of accounts receivable, 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. As a result, the Company categorizes these borrowings as Level 2 in the fair value hierarchy. Contingent Consideration The Company’s contingent consideration of approximately $526,000 as of December 31, 2018, is a Level 3 liability. The fair value of the contingent consideration at December 31, 2018 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 was not possible to determine a range of outcomes. During 2019, the contingent consideration liability was fully 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 Year Ended December 31, 2019 2018 Balance - January 1, $ 526,432 $ 603,411 Change in fair value (343,768 ) 73,271 Payments (182,664 ) (150,250 ) Balance - December 31, $ - $ 526,432

Subsequent Event

Subsequent Event	12 Months Ended
	Dec. 31, 2019
Subsequent Events [Abstract]
Subsequent Event	20. SUBSEQUENT EVENT On January 8, 2020, the Company entered into an Agreement and Plan of Merger (the “Merger Agreement”) with CareCloud Corporation, a Delaware corporation (“CareCloud”), MTBC Merger Sub, Inc., a Delaware corporation and wholly-owned subsidiary of the Company (“Merger Sub”) and Runway Growth Credit Fund Inc. (“Runway”), solely in its capacity as a seller representative, pursuant to which Merger Sub merged with and into CareCloud (the “Merger”), with CareCloud surviving as a wholly-owned subsidiary of the Company. The Merger became effective simultaneously with the execution of the Merger Agreement. CareCloud was the surviving corporation of the Merger and became a wholly-owned subsidiary of the Company. The total consideration for the Merger paid at closing was $11.9 million in cash, the assumption of a working capital deficiency of approximately $5.1 million and 760,000 shares of the Company’s Preferred Stock. The Merger Agreement provides that if CareCloud’s 2020 revenues exceed $36 million, there will be an earn-out payment to the seller equal to such excess, up to $3 million. Additional consideration included warrants to purchase 2,000,000 shares of the Company’s common stock, 1,000,000 of which have an exercise price per share of $7.50 and a term of two years, and the other 1,000,000 warrants have an exercise price per share of $10.00 and a term of three years. Of the Preferred Stock consideration, 160,000 shares will be held in escrow for up to 24 months, and an additional 100,000 shares will be held in escrow for up to 18 months, in both cases, to satisfy indemnification obligations of the seller for losses arising from certain specified contingent liabilities. Shares net of such losses will be released upon joint instruction of the Company and Runway in accordance with the applicable escrow terms. The Company’s Preferred Stock and warrants being issued as part of the Merger consideration were issued in a transaction exempt from registration under the Securities Act of 1933, as amended (the “Securities Act”). The Company has agreed that, as soon as practicable after the completion of CareCloud’s 2019 financial statements audit, the Company will register for resale under the Securities Act the Preferred Stock and the securities underlying the warrants.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Principles of Consolidation	Principles of Consolidation
Segment Reporting	Segment Reporting
Use of Estimates	Use of Estimates
Revenue Recognition	Revenue Recognition Revenue from Contracts with Customers We derive revenue from seven primary sources: (1) revenue cycle management services, (2) professional services, (3) ancillary services, (4) group purchasing services, (5) printing and mailing services, (6) clearinghouse and EDI (electronic data interchange) services and (7) practice management services. All of our revenue arrangements are based on contracts with customers. Most of our contracts with customers contain single performance obligations, although certain contracts do contain multiple performance obligations where we perform more than one service for the same customer. We account for individual performance obligations separately if they are distinct within the context of the contract. For contracts where we provide multiple services such as where we perform multiple ancillary services, each service represents its own performance obligation. Selling or transaction prices are based on the contractual price for the service. A five-step approach is applied in the recognition of revenue under ASC 606: (1) identify the contract with a customer, (2) identify the performance obligations in the contract, (3) determine the transaction price, (4) allocate the transaction price to the performance obligations in the contract, and (5) recognize revenue when we satisfy a performance obligation. Although we believe that our approach to estimates and judgments is reasonable, actual results could differ, and we may be exposed to increases or decreases in revenue that could be material. Our estimates of variable consideration may prove to be inaccurate, in which case we may have understated or overstated the revenue recognized in a reporting period. The amount of variable consideration recognized to date that remains subject to estimation is included within the contract asset within the consolidated balance sheet. Payment of invoices is due as specified in the underlying customer agreement, typically 30 days from the invoice date, which occurs on the date of transfer of control of the services to the customer. Since payment terms are less than a year, we have elected the practical expedient and do not assess whether a customer contract has a significant financing component. The Company’s revenue arrangements generally do not include a general right of refund for services provided (See Note 9, Revenue for additional information).
Direct Operating Costs	Direct Operating Costs
Selling and Marketing Expenses	Selling and Marketing Expenses
Research and Development Expenses	Research and Development Expenses
Internal-Use Software Costs	Internal-Use Software Costs
Accounts Receivable	Accounts Receivable The movement in the allowance for doubtful accounts for the years ended December 31, 2019 and 2018 was as follows: December 31, 2019 December 31, 2018 Beginning balance $ 189,000 $ 185,000 Provision 118,000 724,000 Recoveries 316,000 - Write-offs (367,000 ) (720,000 ) Ending balance $ 256,000 $ 189,000
Inventory	Inventory
Property and Equipment	Property and Equipment
Intangible Assets	Intangible Assets
Evaluation of Long-Lived Assets	Evaluation of Long-Lived Assets There was no impairment of internal-use software costs, intangible assets or property and equipment during the years ended December 31, 2019 and 2018, other than the impairment recorded on one right-of-use (“ROU”) asset of approximately $170,000 for the year ended December 31, 2019.
Goodwill	Goodwill st
Treasury Stock	Treasury Stock
Stock-Based Compensation	Stock-Based Compensation
Business Combinations	Business Combinations Business Combinations Acquisition costs are expensed as incurred. During the years ended December 31, 2019 and 2018, the Company incurred approximately $125,000 and $245,000 of professional fees related to the acquisitions discussed in Note 3, which are included in general and administrative expenses in the consolidated statements of operations. Acquisition costs for the CareCloud acquisition discussed in Note 20 were approximately $129,000 for the year ended December 31, 2019 and are included in general and administrative expenses.
Income Taxes	Income Taxes The Company records net deferred tax assets to the extent that these assets will more likely than not be realized. All available positive and negative evidence is considered in making such a determination, including future reversals of existing taxable temporary differences, projected future taxable income, tax planning strategies, and results of recent operations. A valuation allowance would be recorded to reduce deferred income tax assets when it is determined that it is more likely than not that the Company would not be able to realize its deferred income tax assets in the future in excess of their net recorded amount. The Company records uncertain tax positions on the basis of a two-step process whereby (1) the Company determines whether it is more likely than not that the tax positions will be sustained based on the technical merits of the position and (2) for those tax positions that meet the more-likely-than-not recognition threshold, the Company recognizes the largest amount of tax benefit that is greater than 50 percent likely to be realized upon ultimate settlement with the related tax authority. At December 31, 2019 and 2018, the Company did not have any uncertain tax positions that required recognition. Interest and penalties related to uncertain tax positions are recognized in income tax expense. For the years ended December 31, 2019 and 2018, the Company did not recognize any penalties or interest related to unrecognized tax benefits in its consolidated financial statements.
Dividends	Dividends
Deferred Rent	Deferred Rent
Deferred Revenue	Deferred Revenue
Fair Value Measurements	Fair Value Measurements Fair Value Measurement Level 1 — Inputs are unadjusted quoted market prices in active markets for identical assets or liabilities that the Company has the ability to access at the measurement date. Level 2 — Inputs are directly or indirectly observable, which include quoted prices for similar assets and liabilities in active markets, quoted prices for identical or similar assets or liabilities in markets that are not active, inputs other than quoted prices that are observable for the asset or liability and inputs that are derived principally from or corroborated by observable market data by correlation or other means. Level 3 — Inputs are unobservable inputs that are used to measure fair value to the extent observable inputs are not available. The Company’s contingent consideration is a Level 3 liability and is measured at fair value at the end of each reporting period. The Company has certain financial instruments that are not measured at fair value on a recurring basis. These financial instruments are subject to fair value adjustments only in certain circumstances and include cash, accounts receivable, accounts payable and accrued expenses, borrowings under term loans and line of credit, and notes payable. Due to the short term nature of these financial instruments and that the borrowings, with the exception of the payable to the managed practices (see Note 8) bear interest at prevailing market rates, the carrying value approximates the fair value.
Foreign Currency Translation	Foreign Currency Translation
Stock Offering Costs	Stock Offering Costs —
Restructuring and Impairment Charges	Restructuring and Impairment Charges —
Debt Acquisition Costs	Debt Acquisition Costs —
Recent Accounting Pronouncements	Recent Accounting Pronouncements In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses: Measurement of Credit Losses on Financial Instruments. In February 2016, the FASB issued ASU No. 2016-02, Leases (Topic 842). We adopted the standard on January 1, 2019 using the optional transition adjustment method. As part of the adoption of ASC 842, we performed an assessment of the impact that the new lease recognition standard has on the consolidated financial statements. All of our leases, which consist of facility and equipment leases, have been classified as operating leases. The Company does not have any financing leases. We adopted the requirements of the new standard without restating the prior periods. There was no impact to the accumulated deficit as of the date of adoption. For leases in place at the transition date, we adopted the package of practical expedients that allows us to not reassess: (1) whether any expired or existing contracts are or contain leases, (2) lease classification for any expired or existing leases and (3) initial direct costs for any expired or existing leases. We have also adopted the practical expedients that allow us to treat the lease and non-lease components of our leases as a single component for our facility leases. We elected the short-term lease recognition exemption for all leases that qualify. As such, for those leases that qualify, we did not recognize ROU asset or lease liabilities as part of the transition adjustment. As of January 1, 2019, the impact on the consolidated assets was approximately $4.2 million and the impact on the consolidated liabilities was approximately $4.4 million. The adoption of ASC 842 did not have a material effect on the Company’s results of operations, stockholders’ equity, or statement of cash flows. 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. In June 2018, the FASB issued ASU 2018-07, Improvements to Nonemployee Share-Based Payment Accounting In December 2019, the FASB issued ASU 2019-12, Simplifying the Accounting for Income Taxes

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	12 Months Ended
	Dec. 31, 2019
Accounting Policies [Abstract]
Schedule of Allowance for Doubtful Accounts	The movement in the allowance for doubtful accounts for the years ended December 31, 2019 and 2018 was as follows: December 31, 2019 December 31, 2018 Beginning balance $ 189,000 $ 185,000 Provision 118,000 724,000 Recoveries 316,000 - Write-offs (367,000 ) (720,000 ) Ending balance $ 256,000 $ 189,000

Acquisitions (Tables)

Acquisitions (Tables)	12 Months Ended
	Dec. 31, 2019
Schedule of Business Acquisition, Pro Forma Information	Year Ended December 31, 2019 2018 ($ in thousands except per share amounts) Total revenue $ 66,480 $ 81,876 Net loss $ (2,372 ) $ (12,387 ) Net loss attributable to common shareholders $ (8,758 ) $ (17,211 ) Net loss per common share $ (0.72 ) $ (1.47 )
2019 Acquisition [Member]
Schedule of Assets Acquired and Liabilities Assumed	The purchase price allocation for ETM was performed by the Company and is summarized as follows: Customer relationships $ 856,000 Accounts receivable 547,377 Contract asset 139,169 Operating lease right-of-use assets 1,224,480 Property and equipment 91,277 Goodwill 39,901 Operating lease liabilities (1,224,480 ) Accrued expenses (73,724 ) Total $ 1,600,000
2018 Acquisition [Member]
Schedule of Assets Acquired and Liabilities Assumed	The Company engaged a third party valuation specialist to assist the Company in valuing the assets and assumed liabilities acquired from Orion. The following table summarizes the purchase price allocation. Customer relationships $ 6,250,000 Accounts receivable 5,654,919 Contract asset 861,341 Inventory 307,278 Property and equipment 319,352 Goodwill 329,852 Accounts payable (677,872 ) Accrued expenses (444,870 ) Total $ 12,600,000

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets - Net (Tables)	12 Months Ended
	Dec. 31, 2019
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Intangible Assets and Goodwill	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 years ended December 31, 2019 and 2018: Year Ended Year Ended December 31, 2019 December 31, 2018 Beginning gross balance $ 12,593,795 $ 12,263,943 Acquisitions 39,901 329,852 Ending gross balance $ 12,633,696 $ 12,593,795
Schedule of Finite-Lived Intangible Assets	Below is a summary of intangible asset activity for the years ended December 31, 2019 and 2018: Customer Non-Compete Other Intangible Relationships Agreements Assets Total COST Balance, January 1, 2019 $ 22,741,300 $ 1,236,377 $ 1,477,059 $ 25,454,736 Capitalized software costs and other intangible assets - - 591,509 591,509 Translation loss - - (41,098 ) (41,098 ) Disposals - - - - Allocation from 2019 acquisition 856,000 - - 856,000 Balance, December 31, 2019 $ 23,597,300 $ 1,236,377 $ 2,027,470 $ 26,861,147 Useful lives 3-12 Years 3 Years 3 Years ACCUMULATED AMORTIZATION Balance, January 1, 2019 $ 16,457,878 $ 1,234,774 $ 1,128,081 $ 18,820,733 Amortization expense 1,855,634 1,601 205,954 2,063,189 Balance, December 31, 2019 18,313,512 1,236,375 1,334,035 20,883,922 Net book value $ 5,283,788 $ 2 $ 693,435 $ 5,977,225 COST Balance, January 1, 2018 $ 16,491,300 $ 1,236,377 $ 1,498,417 $ 19,226,094 Capitalized software costs and other intangible assets - - 108,552 108,552 Translation loss - - (129,910 ) (129,910 ) Allocation from 2018 acquisition 6,250,000 - - 6,250,000 Balance, December 31, 2018 $ 22,741,300 $ 1,236,377 $ 1,477,059 $ 25,454,736 Useful lives 3-12 Years 3 Years 3 Years ACCUMULATED AMORTIZATION Balance, January 1, 2018 $ 14,685,190 $ 1,227,601 $ 803,759 $ 16,716,550 Amortization expense 1,772,688 7,173 324,322 2,104,183 Balance, December 31, 2018 16,457,878 1,234,774 1,128,081 18,820,733 Net book value $ 6,283,422 $ 1,603 $ 348,978 $ 6,634,003
Schedule of Finite-Lived Intangible Assets, Future Amortization Expense	As of December 31, 2019, future amortization expense scheduled to be expensed is as follows: Year ending December 31 2020 $ 1,437,324 2021 1,292,146 2022 959,225 2023 338,530 2024 300,000 Thereafter 1,650,000 Total $ 5,977,225

Property and Equipment (Tables)

Property and Equipment (Tables)	12 Months Ended
	Dec. 31, 2019
Property, Plant and Equipment [Abstract]
Schedule of Property and Equipment	Property and equipment as of December 31, 2019 and 2018 consisted of the following: December 31, 2019 December 31, 2018 Computer equipment $ 2,905,892 $ 2,389,865 Office furniture and equipment 1,145,617 1,089,014 Transportation equipment 806,009 828,417 Leasehold improvements 931,955 727,519 Assets not placed in service 1,004,252 50,362 Total property and equipment 6,793,725 5,085,177 Less accumulated depreciation (3,886,209 ) (3,252,990 ) Property and equipment – net $ 2,907,516 $ 1,832,187

Concentrations (Tables)

Concentrations (Tables)	12 Months Ended
	Dec. 31, 2019
Risks and Uncertainties [Abstract]
Schedule of Concentration of Risk, by Geographical Risks Factor	The following is a summary of the net assets located outside the United States as of December 31, 2019 and 2018: December 31, 2019 2018 Current assets $ 1,082,233 $ 156,265 Non-current assets 2,242,816 1,259,446 3,325,049 1,415,711 Current liabilities (1,270,015 ) (1,044,539 ) Non-current liabilities (332,276 ) (209,333 ) Net assets $ 1,722,758 $ 161,839

Net Loss Per Common Share (Tabl

Net Loss Per Common Share (Tables)	12 Months Ended
	Dec. 31, 2019
Earnings Per Share [Abstract]
Schedule of Losses Per Share, Basic and Diluted	The following table reconciles the weighted-average shares outstanding for basic and diluted net loss per common share for the years ended December 31, 2019 and 2018: Year Ended December 31, 2019 2018 Basic and Diluted: Net loss attributable to common shareholders $ (7,257,954 ) $ (6,962,467 ) Weighted-average common shares used to compute basic and diluted loss per share 12,087,947 11,721,232 Net loss attributable to common shareholders per share - Basic and Diluted $ (0.60 ) $ (0.59 )

Debt (Tables)

Debt (Tables)	12 Months Ended
	Dec. 31, 2019
Debt Disclosure [Abstract]
Schedule of Maturities of Long-term Debt	Maturities of the outstanding notes payable and other obligations as of December 31, 2019 are as follows: Year ending December 31 Vehicle Insurance Financing Payable to Managed Total 2020 $ 67,129 $ 132,546 $ 84,000 $ 283,675 2021 37,410 - 26,000 63,410 2022 15,171 - - 15,171 2023 4,694 - - 4,694 Total $ 124,404 $ 132,546 $ 110,000 $ 366,950

Revenue (Tables)

Revenue (Tables)	12 Months Ended
	Dec. 31, 2019
Revenue from Contract with Customer [Abstract]
Schedule of Disaggregation of Revenue	The following table represents a disaggregation of revenue for the years ended December 31, 2019 and 2018: Year Ended 2019 2018 Healthcare IT: Revenue cycle management services $ 42,919,944 $ 38,559,180 Professional services 1,769,129 1,244,894 Ancillary services 3,220,372 1,594,364 Group purchasing services 1,020,031 654,805 Printing and mailing services 1,650,069 1,344,011 Clearinghouse and EDI services 591,963 647,446 Practice Management: Practice management services 13,267,086 6,501,081 Total $ 64,438,594 $ 50,545,781
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, Contract Deferred Deferred Revenue Balance as of January 1, 2018 $ 3,879,463 $ 1,342,692 $ 62,104 $ 28,615 Orion acquisition 5,654,919 861,341 - - (Decrease) increase, net (2,202,908 ) 404,598 (36,749 ) (9,666 ) Balance as of December 31, 2018 $ 7,331,474 $ 2,608,631 $ 25,355 $ 18,949 Balance as of January 1, 2019 $ 7,331,474 $ 2,608,631 $ 25,355 $ 18,949 ETM acquisition - 139,169 - - Decrease, net (336,131 ) (362,466 ) (5,078 ) (204 ) Balance as of December 31, 2019 $ 6,995,343 $ 2,385,334 $ 20,277 $ 18,745

Leases (Tables)

Leases (Tables)	12 Months Ended
	Dec. 31, 2019
Leases [Abstract]
Schedule of Lease Expense	The components of lease expense were as follows: Year Ended Operating lease cost $ 2,184,880 Short-term lease cost 229,263 Variable lease cost 41,714 Total- net lease cost $ 2,455,857
Schedule of Supplemental Balance Sheet Information Related to Leases	Supplemental balance sheet information related to leases was as follows: December 31, 2019 Operating leases: Operating lease ROU assets, net $ 3,526,315 Current operating lease liabilities $ 1,688,772 Non-current operating lease liabilities 2,040,772 Total operating lease liabilities $ 3,729,544 Operating leases: ROU assets $ 5,467,749 Asset lease expense (1,888,443 ) Foreign exchange loss (52,991 ) ROU assets, net $ 3,526,315 Weighted average remaining lease term (in years): Operating leases 2.46 Weighted average discount rate: Operating leases 7.05 %
Schedule of Supplemental Cash Flow and Other Information Related to Leases	Supplemental cash flow and other information related to leases was as follows: Year Ended Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 2,332,167 ROU assets obtained in exchange for lease liabilities: Operating leases, net of restructuring, impairment and terminations $ 1,221,989
Schedule of Maturities of Lease Liabilities	Maturities of lease liabilities are as follows: Operating leases - Year ended December 31, 2020 $ 1,887,651 2021 1,382,639 2022 624,528 2023 154,492 2024 4,694 Total lease payments 4,054,004 Less: imputed interest (324,460 ) Total lease obligations 3,729,544 Less: current obligations 1,688,772 Long-term lease obligations $ 2,040,772
Schedule of Future Minimum Lease Payments Under Non-cancellable Operating Leases	For comparative periods prior to the adoption of the new accounting guidance on January 1, 2019, we have retained the following disclosures as previously reported. Future minimum lease payments under non-cancelable operating leases as of December 31, 2018 were as follows: Operating leases 2019 $ 932,068 2020 715,059 2021 510,927 2022 412,585 2023 91,797 Total $ 2,662,436

Stock-Based Compensation (Table

Stock-Based Compensation (Tables)	12 Months Ended
	Dec. 31, 2019
Share-based Payment Arrangement [Abstract]
Disclosure of Share-based Compensation Arrangements by Share-based Payment Award	The following table summarizes the RSU and restricted stock transactions related to the common and Preferred Stock under the Amended and Restated Incentive Plan for the years ended December 31, 2019 and 2018: Common Stock Preferred Stock Outstanding and unvested shares at January 1, 2018 605,969 39,800 Granted 707,200 44,800 Vested (340,066 ) (39,800 ) Forfeited (43,756 ) - Outstanding and unvested shares at December 31, 2018 929,347 44,800 Granted 180,000 48,746 Vested (624,315 ) (49,546 ) Forfeited (33,948 ) - Outstanding and unvested shares at December 31, 2019 451,084 44,000
Schedule of Share-based Compensation, Restricted Stock Units Award Activity	The following table summarizes the share activity during the years ended December 31, 2019 and 2018 and the amount of common and Preferred Shares available for grant at December 31, 2019: Common Stock Preferred Stock Shares available for grant at January 1, 2018 1,211,234 27,200 Additional shares available for grant - 200,000 RSUs granted (707,200 ) (44,800 ) RSUs forfeited 43,756 - Shares available for grant at December 31, 2018 547,790 182,400 RSUs granted (180,000 ) (48,746 ) RSUs forfeited 33,948 - Shares available for grant at December 31, 2019 401,738 133,654
Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs	The following table summarizes the components of stock-based compensation expense for the years ended December 31, 2019 and 2018: Stock-based compensation included in the December 31, 2019 2018 Direct operating costs $ 196,956 $ 88,195 General and administrative 2,735,178 2,352,850 Research and development 33,029 14,506 Selling and marketing 250,498 8,048 Total stock-based compensation expense $ 3,215,661 $ 2,463,599

Income Taxes (Tables)

Income Taxes (Tables)	12 Months Ended
	Dec. 31, 2019
Income Tax Disclosure [Abstract]
Schedule of Deferred Tax Valuation Allowance	The activity in the deferred tax valuation allowance was as follows for the years ended December 31, 2019 and 2018: Year ended December 31, 2019 2018 Beginning balance $ 7,176,391 $ 6,620,464 Provision 371,468 400,158 Adjustments/true-ups (393,349 ) 155,769 Ending balance $ 7,154,510 $ 7,176,391
Schedule of Income Before Income Tax, Domestic and Foreign	The loss before tax for financial reporting purposes during the years ended December 31, 2019 and 2018 consisted of the following: Year ended December 31, 2019 2018 United States $ (1,154,831 ) $ (4,111,539 ) Foreign 475,811 1,815,674 Total $ (679,020 ) $ (2,295,865 )
Schedule of Components of Income Tax Expense (Benefit)	The provision (benefit) for income taxes for the years ended December 31, 2019 and 2018 consisted of the following: Year ended December 31, 2019 2018 Current: Federal $ - $ - State 102,677 49,000 Foreign 9,937 1,341 112,614 50,341 Deferred: Federal 27,689 (225,347 ) State 52,477 17,621 80,166 (207,726 ) Total income tax provision (benefit) $ 192,780 $ (157,385 )
Schedule of Deferred Tax Assets and Liabilities	The components of the Company’s deferred income taxes as of December 31, 2019 and 2018 are as follows: December 31, 2019 December 31, 2018 Deferred tax assets: Allowance for doubtful accounts $ 65,529 $ 46,492 Deferred revenue 4,807 4,664 Deferred rent - 4,275 Property and intangible assets 2,301,987 2,336,221 State net operating loss (“NOL”) carryforwards 910,274 636,578 Federal net operating loss (“NOL”) carryforwards 4,146,274 3,789,618 Section 163(j) interest limitation 13,499 51,319 Cumulative translation adjustment 216,255 349,834 Stock based compensation 118,377 335,785 ASC 606 - Section 481(A) adjustment (185,162 ) - ASC 842-ROU asset (790,446 ) - ASC 842 - Lease liability 799,376 - Other 18,238 (24,654 ) Valuation allowance (7,154,510 ) (7,176,391 ) Total deferred tax assets 464,498 353,741 Deferred tax liabilities: Goodwill amortization (709,010 ) (518,087 ) Net deferred tax liability $ (244,512 ) $ (164,346 )
Schedule of Effective Income Tax Rate Reconciliation	A reconciliation of the federal statutory income tax rate (21%) for 2019 and 2018 to the Company’s effective income tax rate (determined in dollars) for the years ended December 31, 2019 and 2018 is as follows: Year ended December 31, 2019 2018 Federal benefit at statutory rate $ (142,594 ) $ (482,132 ) Increase (decrease) in income taxes resulting from: State tax expense, net of federal benefit 142,079 29,646 Non-deductible items 24,883 15,332 Impact of foreign operations 31,408 (525,583 ) Subpart F GILTI inclusion 69,862 360,742 Deferred true-up 332,792 (142,869 ) Valuation allowance (304,009 ) 555,927 Additional tax goodwill/contingent consideration 38,359 31,553 Total income tax provision (benefit) $ 192,780 $ (157,385 )

Other (Expense) Income - Net (T

Other (Expense) Income - Net (Tables)	12 Months Ended
	Dec. 31, 2019
Other Income and Expenses [Abstract]
Schedule of Other (Expense) Income - Net	Other (expense) income - net for the years ended December 31, 2019 and 2018 consisted of the following: Year Ended December 31, 2019 2018 Foreign exchange (loss) gain $ (827,121 ) $ 434,806 Other income 201,446 59,526 Other (expense) income - net $ (625,675 ) $ 494,332

Segment Reporting (Tables)

Segment Reporting (Tables)	12 Months Ended
	Dec. 31, 2019
Segment Reporting [Abstract]
Schedule of Revenues, Operating Expenses and Operating Income (Loss) by Reportable Segment	The accounting policies of the segments are the same as those disclosed in the summary of significant accounting policies. The following tables present revenues, operating expenses and operating income (loss) by reportable segment for the years ended December 31, 2019 and 2018: Year Ended December 31, 2019 Healthcare IT Practice Management Unallocated Corporate Expenses Total Net revenue $ 51,171,508 $ 13,267,086 $ - $ 64,438,594 Operating expenses: Direct operating costs 30,798,404 10,387,620 - 41,186,024 Selling and marketing 1,487,196 34,619 - 1,521,815 General and administrative 11,124,271 2,066,522 4,721,004 17,911,797 Research and development 870,780 - - 870,780 Change in contingent consideration (343,768 ) - - (343,768 ) Depreciation and amortization 2,689,240 316,366 - 3,005,606 Restructuring and impairment charges 219,013 - - 219,013 Total operating expenses 46,845,136 12,805,127 4,721,004 64,371,267 Operating income (loss) $ 4,326,372 $ 461,959 $ (4,721,004 ) $ 67,327 Year Ended December 31, 2018 Healthcare IT Practice Management Unallocated Total Net revenue $ 44,044,700 $ 6,501,081 $ - $ 50,545,781 Operating expenses: Direct operating costs 26,289,770 4,962,765 - 31,252,535 Selling and marketing 1,593,052 18,930 - 1,611,982 General and administrative 9,834,749 1,164,505 5,265,219 16,264,473 Research and development 1,029,510 - - 1,029,510 Change in contingent consideration 73,271 - - 73,271 Depreciation and amortization 2,700,577 153,250 - 2,853,827 Total operating expenses 41,520,929 6,299,450 5,265,219 53,085,598 Operating income (loss) $ 2,523,771 $ 201,631 $ (5,265,219 ) $ (2,539,817 )

Fair Value of Financial Instr_2

Fair Value of Financial Instruments (Tables)	12 Months Ended
	Dec. 31, 2019
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 Year Ended December 31, 2019 2018 Balance - January 1, $ 526,432 $ 603,411 Change in fair value (343,768 ) 73,271 Payments (182,664 ) (150,250 ) Balance - December 31, $ - $ 526,432

Organization and Business (Deta

Organization and Business (Details Narrative)	Dec. 31, 2004
Executive Chairman [Member]
Equity method investment, ownership percentage in majority-owned subsidiary based in Pakistan	0.01%
MTBC Private Limited [Member]
Equity method investment, ownership percentage in majority-owned subsidiary based in Pakistan	99.90%

Significant Accounting Polici_4

Significant Accounting Policies (Details Narrative)	12 Months Ended
	Dec. 31, 2019USD ($)Segmentshares	Dec. 31, 2018USD ($)shares	Jan. 02, 2019USD ($)
Number of operating segments | Segment	2
Advertising costs	$ 810,000	$ 950,000
Capitalized software cost	$ 538,000	62,000
Depreciation calculation period	Depreciation for computers is calculated over three years, while remaining assets (except leasehold improvements) are depreciated over five years.
Intangible assets amortized period, description	Straight line basis over four and twelve years
Impairment of internal-use software costs
Impairment on right of use asset	170,000
Impairment of goodwill
Treasury stock, share, repurchased | shares
Professional fees	$ 125,000	$ 245,000
Income tax likely to be realized upon ultimate settlement, description	Greater than 50 percent
Uncertain tax positions
Penalties or interest related to unrecognized tax benefits
Foreign currency transaction gain (loss), before tax	(827,121)	434,806
Operating lease right-of-use assets	3,526,315
Liabilities	3,729,544
ASC 842 [Member]
Operating lease right-of-use assets			$ 4,200,000
Liabilities			$ 4,400,000
Equity Offerings [Member]
Adjustments to additional paid in capital, stock issued, issuance costs	110,000	$ 282,000
CareCloud Acquisition [Member]
Acquisition costs	$ 129,000
Minimum [Member]
Estimated lives of the assets	3 years
Intangible assets amortized period	3 years
Maximum [Member]
Estimated lives of the assets	5 years
Intangible assets amortized period	4 years

Significant Accounting Polici_5

Significant Accounting Policies - Schedule of Allowance for Doubtful Accounts (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Accounting Policies [Abstract]
Beginning balance	$ 189,000	$ 185,000
Provision	118,000	724,000
Recoveries	316,000
Write-offs	(367,000)	(720,000)
Ending balance	$ 256,000	$ 189,000

Acquisitions (Details Narrative

Acquisitions (Details Narrative) - USD ($)	Apr. 03, 2019	May 07, 2018	Dec. 31, 2019	Dec. 31, 2018
Purchase price amount			$ 2,558,159	$ 1,028,249
ETM Acquisition [Member]
Revenue earned from acquisition			5,100,000
Orion Acquisition [Member]
Revenue earned from acquisition			$ 29,000,000
Asset Purchase Agreement [Member]
Purchase price amount	$ 1,600,000	$ 12,600,000
Acquisition-related costs	$ 125,000	$ 245,000
Period over which goodwill is deductible for income tax purposes	15 years	15 years
Weighted-average amortization period of acquired intangible assets	3 years	8 years

Acquisitions - Schedule of Asse

Acquisitions - Schedule of Assets Acquired and Liabilities Assumed (Details) - USD ($)	Dec. 31, 2019	Dec. 31, 2018
Goodwill	$ 12,633,696	$ 12,593,795
2019 Acquisition [Member]
Customer relationships	856,000
Accounts receivable	547,377
Contract asset	139,169
Operating lease right-of-use assets	1,224,480
Property and equipment	91,277
Goodwill	39,901
Operating lease liabilities	(1,224,480)
Accrued expenses	(73,724)
Business combination, net	1,600,000
2018 Acquisition [Member]
Customer relationships	6,250,000
Accounts receivable	5,654,919
Contract asset	861,341
Inventory	307,278
Property and equipment	319,352
Goodwill	329,852
Accounts payable	(677,872)
Accrued expenses	(444,870)
Business combination, net	$ 12,600,000

Acquisitions - Schedule of Busi

Acquisitions - Schedule of Business Acquisition, Pro Forma Information (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Business Combinations [Abstract]
Total revenue	$ 66,480,000	$ 81,876,000
Net loss	(2,372,000)	(12,387,000)
Net loss attributable to common shareholders	$ (8,758,000)	$ (17,211,000)
Net loss per common share	$ (0.72)	$ (1.47)

Goodwill and Intangible Asset_3

Goodwill and Intangible Assets - Net (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Goodwill	$ 12,633,696	$ 12,593,795
Amortization expenses	$ 2,063,189	$ 2,104,183
Weighted-average amortization period	7 years	7 years
Practice Management Segment and Healthcare IT Segment [Member]
Goodwill	$ 90,000	$ 90,000

Goodwill and Intangible Asset_4

Goodwill and Intangible Assets - Net - Schedule of Intangible Assets and Goodwill (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
Beginning gross balance	$ 12,593,795	$ 12,263,943
Acquisitions	39,901	329,852
Ending gross balance	$ 12,633,696	$ 12,593,795

Goodwill and Intangible Asset_5

Goodwill and Intangible Assets - Net - Schedule of Finite-Lived Intangible Assets (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Finite-Lived Intangible Assets [Line Items]
Beginning Balance	$ 25,454,736	$ 19,226,094
Capitalized software costs and other intangible assets	591,509	108,552
Translation loss	(41,098)	(129,910)
Disposals
Allocation from 2019/2018 acquisition	856,000	6,250,000
Ending Balance	26,861,147	25,454,736
Beginning Balance	18,820,733	16,716,550
Amortization expense	2,063,189	2,104,183
Ending Balance	20,883,922	18,820,733
Net book value	$ 5,977,225	6,634,003
Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives	3 years
Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives	4 years
Customer Relationships [Member]
Finite-Lived Intangible Assets [Line Items]
Beginning Balance	$ 22,741,300	16,491,300
Capitalized software costs and other intangible assets
Translation loss
Disposals
Allocation from 2019/2018 acquisition	856,000	6,250,000
Ending Balance	23,597,300	22,741,300
Beginning Balance	16,457,878	14,685,190
Amortization expense	1,855,634	1,772,688
Ending Balance	18,313,512	16,457,878
Net book value	$ 5,283,788	$ 6,283,422
Customer Relationships [Member] | Minimum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives	3 years	3 years
Customer Relationships [Member] | Maximum [Member]
Finite-Lived Intangible Assets [Line Items]
Useful lives	12 years	12 years
Non-Compete Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Beginning Balance	$ 1,236,377	$ 1,236,377
Capitalized software costs and other intangible assets
Translation loss
Disposals
Allocation from 2019/2018 acquisition
Ending Balance	$ 1,236,377	$ 1,236,377
Useful lives	3 years	3 years
Beginning Balance	$ 1,234,774	$ 1,227,601
Amortization expense	1,601	7,173
Ending Balance	1,236,375	1,234,774
Net book value	2	1,603
Other Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Beginning Balance	1,477,059	1,498,417
Capitalized software costs and other intangible assets	591,509	108,552
Translation loss	(41,098)	(129,910)
Disposals
Allocation from 2019/2018 acquisition
Ending Balance	$ 2,027,470	$ 1,477,059
Useful lives	3 years	3 years
Beginning Balance	$ 1,128,081	$ 803,759
Amortization expense	205,954	324,322
Ending Balance	1,334,035	1,128,081
Net book value	$ 693,435	$ 348,978

Goodwill and Intangible Asset_6

Goodwill and Intangible Assets - Net - Schedule of Finite-Lived Intangible Assets, Future Amortization Expense (Details) - USD ($)	Dec. 31, 2019	Dec. 31, 2018
Goodwill and Intangible Assets Disclosure [Abstract]
2020	$ 1,437,324
2021	1,292,146
2022	959,225
2023	338,530
2024	300,000
Thereafter	1,650,000
Total	$ 5,977,225	$ 6,634,003

Property and Equipment (Details

Property and Equipment (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Property, Plant and Equipment [Abstract]
Depreciation expense	$ 909,000	$ 688,000

Property and Equipment - Schedu

Property and Equipment - Schedule of Property and Equipment (Details) - USD ($)	Dec. 31, 2019	Dec. 31, 2018
Total property and equipment	$ 6,793,725	$ 5,085,177
Less accumulated depreciation	(3,886,209)	(3,252,990)
Property and equipment - net	2,907,516	1,832,187
Computer Equipment [Member]
Total property and equipment	2,905,892	2,389,865
Office Furniture and Equipment [Member]
Total property and equipment	1,145,617	1,089,014
Transportation Equipment [Member]
Total property and equipment	806,009	828,417
Leasehold Improvements [Member]
Total property and equipment	931,955	727,519
Assets Not Placed in Service [Member]
Total property and equipment	$ 1,004,252	$ 50,362

Concentrations (Details Narrati

Concentrations (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Fair value, concentration of risk, cash and cash equivalents	$ 1,000,000	$ 77,000
Non-United States [Member]
Net assets	1,722,758	161,839
Intercompany receivables	$ 7,100,000	$ 7,600,000
Customer One [Member] | Accounts Receivable Net [Member]
Concentration risk percentage	9.00%	8.00%
Customer Two [Member] | Accounts Receivable Net [Member]
Concentration risk percentage	5.00%	7.00%
One Customer [Member] | Sales Revenue, Net [Member]
Concentration risk percentage	10.00%	10.00%

Concentrations - Schedule of Co

Concentrations - Schedule of Concentration of Risk, by Geographical Risks Factor (Details) - USD ($)	Dec. 31, 2019	Dec. 31, 2018
Current assets	$ 31,002,135	$ 26,073,673
Assets	56,403,465	47,623,361
Current liabilities	(11,177,836)	(8,157,946)
Non-United States [Member]
Current assets	1,082,233	156,265
Non-current assets	2,242,816	1,259,446
Assets	3,325,049	1,415,711
Current liabilities	(1,270,015)	(1,044,539)
Non-current liabilities	(332,276)	(209,333)
Net assets	$ 1,722,758	$ 161,839

Net Loss Per Common Share (Deta

Net Loss Per Common Share (Details Narrative)	12 Months Ended
	Dec. 31, 2019shares
Opus Bank [Member]
Antidilutive securities excluded from computation of earning per share, warrants	200,000
Silicon Valley Bank [Member]
Antidilutive securities excluded from computation of earning per share, warrants	153,489

Net Loss Per Common Share - Sch

Net Loss Per Common Share - Schedule of Losses Per Share, Basic and Diluted (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Earnings Per Share [Abstract]
Net loss attributable to common shareholders	$ (7,257,954)	$ (6,962,467)
Weighted-average common shares used to compute basic and diluted loss per share	12,087,947	11,721,232
Net loss attributable to common shareholders per share - Basic and Diluted	$ (0.60)	$ (0.59)

Debt (Details Narrative)

Debt (Details Narrative) - USD ($)	1 Months Ended	12 Months Ended
	Oct. 31, 2017	Dec. 31, 2019	Dec. 31, 2018	Sep. 30, 2018
Debt balance payable		$ 366,950
Vehicle Financing Notes [Member]
Vehicle financing in United stated and Pakistan		Three to six year terms
Debt balance payable		$ 124,404
Insurance Financing [Member]
Debt instrument interest rate		4.52%
Debt balance payable		$ 132,546
Payable to Managed Practices [Member]
Debt balance payable		110,000
Payable to Managed Practices [Member] | Orion Acquisition [Member]
Non-interest bearing		$ 236,000
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
Decrease in interest rate due to increase in line of credit		0.25%
Upfront fee paid for increase in SVB credit line limit		$ 50,000
SVB Debt Agreement [Member] | Additional Warrant [Member]
Class of warrant or right, number of securities called by warrants or rights		28,489
Warrant strike price		$ 5.26
Warrant exercise term		5 years
Warrants price per share		$ 3.58
SVB Credit Facility [Member]
Secured revolving line of credit percentage	200.00%
Borrowing credit facility
Unused portion of credit line fee, percentage	1.00%
Unused portion of credit line fee percentage, description	There is also a fee of one-half of 1% annually for the unused portion of the credit line.
Percentage of shares in offshore facilities secured for SVB credit line	65.00%
SVB Credit Facility [Member] | Prime Rate [Member]
Revolving line of credit, interest rate	1.50%
SVB Credit Facility [Member] | Old [Member]
Revision of borrowing limit from SVB Bank	$ 5,000,000		5,000,000
SVB Credit Facility [Member] | New [Member]
Revision of borrowing limit from SVB Bank			$ 10,000,000	$ 10,000,000

Debt - Schedule of Maturities o

Debt - Schedule of Maturities of Long-term Debt (Details)	Dec. 31, 2019USD ($)
Debt Instrument [Line Items]
2020	$ 283,675
2021	63,410
2022	15,171
2023	4,694
Total	366,950
Vehicle Financing Notes [Member]
Debt Instrument [Line Items]
2020	67,129
2021	37,410
2022	15,171
2023	4,694
Total	124,404
Insurance Financing [Member]
Debt Instrument [Line Items]
2020	132,546
2021
2022
2023
Total	132,546
Payable to Managed Practices [Member]
Debt Instrument [Line Items]
2020	84,000
2021	26,000
2022
2023
Total	$ 110,000

Revenue (Details Narrative)

Revenue (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Deferred commissions	$ 29,000	$ 93,000
Revenue Cycle Management and Orion Acquisition [Member]
Remaining performance obligations	2,000,000
Orion Acquisition [Member]
Contract asset represents revenue earned, not paid from group purchasing services	$ 374,000
Estimated recognition period for remaining performance obligations	3 months

Revenue - Schedule of Disaggreg

Revenue - Schedule of Disaggregation of Revenue (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Total	$ 64,438,594	$ 50,545,781
Healthcare IT [Member]
Total	51,171,508	44,044,700
Healthcare IT [Member] | Revenue Cycle Management Services [Member]
Total	42,919,944	38,559,180
Healthcare IT [Member] | Professional Services [Member]
Total	1,769,129	1,244,894
Healthcare IT [Member] | Ancillary Services [Member]
Total	3,220,372	1,594,364
Healthcare IT [Member] | Group Purchasing Services [Member]
Total	1,020,031	654,805
Healthcare IT [Member] | Printing and Mailing Services [Member]
Total	1,650,069	1,344,011
Healthcare IT [Member] | Clearinghouse and EDI Services [Member]
Total	591,963	647,446
Practice Management [Member]
Total	13,267,086	6,501,081
Practice Management [Member] | Practice Management Services [Member]
Total	$ 13,267,086	$ 6,501,081

Revenue - Schedule of Accounts

Revenue - Schedule of Accounts Receivable, Contract Asset and Deferred Revenue (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Beginning balance	$ 26,073,673
Ending balance	31,002,135	$ 26,073,673
Deferred Revenue (Current) [Member]
Beginning balance	25,355	62,104
Orion acquisition
(Decrease) increase, net	(5,078)	(36,749)
ETM acquisition
Ending balance	20,277	25,355
Deferred Revenue (Long Term) [Member]
Beginning balance	18,949	28,615
Orion acquisition
(Decrease) increase, net	(204)	(9,666)
ETM acquisition
Ending balance	18,745	18,949
Accounts Receivable Net [Member]
Beginning balance	7,331,474	3,879,463
Orion acquisition		5,654,919
(Decrease) increase, net	(336,131)	(2,202,908)
ETM acquisition
Ending balance	6,995,343	7,331,474
Contract Asset [Member]
Beginning balance	2,608,631	1,342,692
Orion acquisition		861,341
(Decrease) increase, net	(362,466)	404,598
ETM acquisition	139,169
Ending balance	$ 2,385,334	$ 2,608,631

Shareholders' Equity (Details N

Shareholders' Equity (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Treasury Stock [Member]
Class of Stock [Line Items]
Stock repurchase program expiration date	Jan. 25, 2017
Stock repurchased during period, shares	740,799
Stock repurchased during period, value	$ 662,000
Preferred Stock [Member]
Class of Stock [Line Items]
Number of stock shares issued during the period	373,000
Net proceeds from issuance of preferred stock	$ 9,600,000
Shares issued, price per share		$ 25	$ 25
Preferred stock, liquidation preference per share			$ 25
Preferred Stock Two [Member]
Class of Stock [Line Items]
Number of stock shares issued during the period		1,000,000
Net proceeds from issuance of preferred stock		$ 22,800,000
Cumulative preferred stock dividend per share		$ 2.75
Warrants [Member]
Class of Stock [Line Items]
Warrants to purchase shares of common stock		2,353,489
Remaining warrants outstanding		353,489
Warrants One [Member]
Class of Stock [Line Items]
Warrants to purchase shares of common stock	2,000,000
Warrant exercise price	$ 5
Warrant expiration date	May 31, 2018
Warrants Two [Member]
Class of Stock [Line Items]
Remaining warrants outstanding	100,000
Warrant exercise price	$ 5
Warrant expiration date	Sep. 30, 2022
Warrants Three [Member]
Class of Stock [Line Items]
Remaining warrants outstanding	125,000
Warrant exercise price	$ 3.92
Warrant expiration date	Oct. 31, 2022
Warrants Four [Member]
Class of Stock [Line Items]
Remaining warrants outstanding	100,000
Warrant exercise price	$ 5
Warrant expiration date	Jul. 31, 2023
Warrants Five [Member]
Class of Stock [Line Items]
Remaining warrants outstanding	28,489
Warrant exercise price	$ 5.26
Warrant expiration date	Sep. 30, 2023

Commitments and Contingencies (

Commitments and Contingencies (Details Narrative)	May 30, 2018USD ($)
Commitments and Contingencies Disclosure [Abstract]
Compensatory damages description	RPRWC seeks compensatory damages of $6.6 million, plus costs, for MPMA's alleged breach of the billing services agreement.
Compensatory damages	$ 6,600,000

Leases (Details Narrative)

Leases (Details Narrative)	12 Months Ended
	Dec. 31, 2019USD ($)Integer
Lease term, description	Leases with a term of less than 12 months are not recorded in the condensed consolidated balance sheet.
Lease impairment	$ 170,000
Restructuring charges	$ 49,000
Operating lease term	6 years
Number of operating lease commitment | Integer	1
Operating lease rent expense	$ 1,000,000
Minimum [Member]
Operating lease term	1 year
Maximum [Member]
Operating lease term	4 years

Leases - Schedule of Lease Expe

Leases - Schedule of Lease Expense (Details)	12 Months Ended
	Dec. 31, 2019USD ($)
Leases [Abstract]
Operating lease cost	$ 2,184,880
Short-term lease cost	229,263
Variable lease cost	41,714
Total- net lease cost	$ 2,455,857

Leases - Schedule of Supplement

Leases - Schedule of Supplemental Balance Sheet Information Related to Leases (Details) - USD ($)	Dec. 31, 2019	Dec. 31, 2018
Leases [Abstract]
Operating lease ROU assets, net	$ 3,526,315
Current operating lease liabilities	1,688,772
Non-current operating lease liabilities	2,040,772
Total operating lease liabilities	3,729,544
ROU assets, gross	5,467,749
Asset lease expense	(1,888,443)
Foreign exchange loss	(52,991)
ROU assets, net	$ 3,526,315
Weighted average remaining lease term (in years): Operating leases	2 years 5 months 16 days
Weighted average discount rate: Operating leases	7.05%

Leases - Schedule of Suppleme_2

Leases - Schedule of Supplemental Cash Flow and Other Information Related to Leases (Details)	12 Months Ended
	Dec. 31, 2019USD ($)
Leases [Abstract]
Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases	$ 2,332,167
ROU assets obtained in exchange for lease liabilities: Operating leases, net of restructuring, impairment and terminations	$ 1,221,989

Leases - Schedule of Maturities

Leases - Schedule of Maturities of Lease Liabilities (Details) - USD ($)	Dec. 31, 2019	Dec. 31, 2018
Leases [Abstract]
2020	$ 1,887,651
2021	1,382,639
2022	624,528
2023	154,492
2024	4,694
Total lease payments	4,054,004
Less: imputed interest	(324,460)
Total lease obligations	3,729,544
Less: current obligations	1,688,772
Long-term lease obligations	$ 2,040,772

Leases - Schedule of Future Min

Leases - Schedule of Future Minimum Lease Payments Under Non-cancellable Operating Leases (Details)	Dec. 31, 2019USD ($)
Leases [Abstract]
2019	$ 932,068
2020	715,059
2021	510,927
2022	412,585
2023	91,797
Total	$ 2,662,436

Related Parties (Details Narrat

Related Parties (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Net revenue	$ 64,438,594	$ 50,545,781
Upgradation lease facilities	2,455,857
Operating lease right-of-use assets	3,526,315
Operating lease liability (current portion)	1,688,772
Non-current operating lease liabilities	2,040,772
Related Party Leases [Member]
Operating lease right-of-use assets	566,000
Operating lease liability (current portion)	275,000
Non-current operating lease liabilities	$ 298,000
Nonexclusive Aircraft Dry Lease Agreement [Member]
Original lease expired	Mar. 31, 2019
Nonexclusive Aircraft Dry Lease Agreement [Member] | Kashmir Air, Inc [Member]
Operating leases, rent expense	$ 137,000	128,000
Accrued liability to related party	1,000	11,000
Physician [Member]
Net revenue	21,000	20,000
Receivable balance due from customer	2,000	1,600
Executive Chairman [Member]
Operating leases, rent expense	192,000	187,000
Upgradation lease facilities	330,000
Security deposit	13,000	25,000
Prepaid rent	$ 13,000	$ 25,000

Employee Benefit Plans (Details

Employee Benefit Plans (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
United States Postretirement Benefits Plan of US Entity [Member]
Defined Contribution Plan Disclosure [Line Items]
Defined benefit plan, contributions by employer	$ 255,000	$ 161,000
United States Postretirement Benefits Plan of US Entity [Member] | Qualified Compensation Deferred Plan [Member]
Defined Contribution Plan Disclosure [Line Items]
Defined contribution plan, employer matching contribution, percent of match	100.00%
Percentage of qualified compensation eligible for first matching contribution	3.00%
United States Postretirement Benefits Plan of US Entity [Member] | Qualified Compensation Deferred Plan [Member] | MTBC Health, Inc. [Member]
Defined Contribution Plan Disclosure [Line Items]
Defined contribution plan, employer matching contribution, percent of match	50.00%
Percentage of qualified compensation eligible for next matching contribution	3.00%
United States Postretirement Benefits Plan of US Entity [Member] | Qualified Compensation Deferred Plan [Member] | MTBC Practice Management, Corp. [Member]
Defined Contribution Plan Disclosure [Line Items]
Defined benefit plan, contributions by employer	$ 40,000	$ 56,000
Defined contribution plan, employer matching contribution, percent of employees' gross pay	8.00%	12.00%
United States Postretirement Benefits Plan of US Entity [Member] | Deferred Plan [Member]
Defined Contribution Plan Disclosure [Line Items]
Defined contribution plan, employer matching contribution, percent of match	50.00%
Percentage of qualified compensation eligible for next matching contribution	2.00%
Domestic Postretirement Benefit Plan of Foreign Entity [Member] | Pakistan [Member]
Defined Contribution Plan Disclosure [Line Items]
Defined benefit plan, contributions by employer	$ 245,000	$ 110,000
Employee benefit plan, description	The plan provides for monthly contributions by the Company which are the lower of 10% of qualified employees' basic monthly compensation or 2,500 Pakistani rupees

Stock-based Compensation (Detai

Stock-based Compensation (Details Narrative) - USD ($)	3 Months Ended	12 Months Ended
	Sep. 30, 2018	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017	Apr. 30, 2014
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Liability for cash settled amount		$ 741,000	$ 118,000
Accrued compensation		741,000	118,000
Cash settlement		184,000	39,000
Stock-based compensation expense		$ 3,215,661	$ 2,463,599
Common Stock [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Weighted average grant date fair value		$ 4.87	$ 4.53
Common Stock [Member] | Restricted Shares [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Number of shares available for grant		401,738	547,790	1,211,234
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period		180,000	707,200
Preferred Stock [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share-based compensation arrangement by share-based payment award, number of shares authorized		44,000	40,000
Number of shares added to amended and restated equity incentive plan		373,000
Weighted average grant date fair value		$ 26.77	$ 25
Preferred Stock [Member] | Restricted Shares [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Number of shares available for grant		133,654	182,400	27,200
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period		48,746	44,800
Unrecognized compensation		$ 2,100,000	$ 2,500,000
Unvested stock option award, equity		421,751
Restricted stock award classified as liability		29,333
Preferred Stock [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Number of shares added to amended and restated equity incentive plan			1,000,000
Stock-based compensation expense		$ 1,300,000	$ 1,200,000
One Employee [Member] | Preferred Stock [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share-based compensation arrangement by share-based payment award, number of shares authorized		4,746	4,800
2014 Equity Incentive Plan [Member] | Employees, Officers. Directors and Consultants [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [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] | Restricted Shares [Member] | Four Outsides Members of the Board [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period	68,000	72,000
Granted shares vesting period	2 years	2 years
Shares vesting percentage	25.00%	25.00%
Amended and Restated Equity Incentive Plan [Member] | Common Stock [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Number of shares added to amended and restated equity incentive plan				1,500,000
Number of shares available for grant		401,738
Amended and Restated Equity Incentive Plan [Member] | Preferred Stock [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Number of shares added to amended and restated equity incentive plan			200,000	100,000
Number of shares available for grant		133,654
Amended and Restated Equity Incentive Plan [Member] | Officers and Employees [Member] | Restricted Shares [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period	558,000
Granted shares vesting period	3 years
Amended and Restated Equity Incentive Plan [Member] | Employee [Member] | Restricted Shares [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period		108,000
Amended and Restated Equity Incentive Plan [Member] | Employee [Member] | Restricted Shares [Member] | Pakistan and Sri Lanka [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Share-based compensation arrangement by share-based payment award, equity instruments other than options, grants in period	81,200

Stock-Based Compensation - Disc

Stock-Based Compensation - Disclosure of Share-based Compensation Arrangements by Share-based Payment Award (Details) - Restricted Shares [Member] - shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Common Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding and unvested at beginning	929,347	605,969
Granted	180,000	707,200
Vested	(624,315)	(340,066)
Forfeited	(33,948)	(43,756)
Outstanding and unvested at ending	451,084	929,347
Preferred Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding and unvested at beginning	44,800	39,800
Granted	48,746	44,800
Vested	(49,546)	(39,800)
Forfeited
Outstanding and unvested at ending	44,000	44,800

Stock-based Compensation - Sche

Stock-based Compensation - Schedule of Share-based Compensation, Restricted Stock Units Award Activity (Details) - Restricted Shares [Member] - shares	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Common Stock [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Shares available for grant, beginning	547,790	1,211,234
Additional shares available for grant
RSUs granted	(180,000)	(707,200)
RSUs forfeited	33,948	43,756
Shares available for grant, ending	401,738	547,790
Preferred Stock [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Shares available for grant, beginning	182,400	27,200
Additional shares available for grant		200,000
RSUs granted	(48,746)	(44,800)
RSUs forfeited
Shares available for grant, ending	133,654	182,400

Stock-Based Compensation - Sc_2

Stock-Based Compensation - Schedule of Employee Service Share-based Compensation, Allocation of Recognized Period Costs (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	$ 3,215,661	$ 2,463,599
Direct Operating Costs [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	196,956	88,195
General and Administrative [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	2,735,178	2,352,850
Research and Development [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	33,029	14,506
Selling and Marketing [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	$ 250,498	$ 8,048

Income Taxes (Details Narrative

Income Taxes (Details Narrative) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Goodwill amortization period for tax purposes	15 years
Deferred tax asset net operating loss		$ 208,000
Federal statutory income tax rate	21.00%	21.00%
Federal [Member]
Net operating loss carry forwards	$ 19,800,000
Net operating loss carry forwards expiration period	between 2034 and 2037
Federal [Member] | Between 2034 and 2037 [Member]
Net operating loss carry forwards	$ 15,800,000
Federal [Member] | Indefinite Life [Member]
Net operating loss carry forwards	4,000,000
State [Member]
Net operating loss carry forwards	$ 38,500,000
State [Member] | Minimum [Member]
Tax expiration period	2034
State [Member] | Maximum [Member]
Tax expiration period	2039
New Jersey [Member]
Net operating loss carry forwards	$ 17,900,000
Pakistan [Member]
Federal statutory income tax rate	21.00%	21.00%
Pakistan statutory corporate tax rate	29.00%

Income Taxes - Schedule of Defe

Income Taxes - Schedule of Deferred Tax Valuation Allowance (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Beginning balance	$ 7,176,391	$ 6,620,464
Provision	371,468	400,158
Adjustments/true-ups	(393,349)	155,769
Ending balance	$ 7,154,510	$ 7,176,391

Income Taxes - Schedule of Inco

Income Taxes - Schedule of Income Before Income Tax, Domestic and Foreign (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
United States	$ (1,154,831)	$ (4,111,539)
Foreign	475,811	1,815,674
Total	$ (679,020)	$ (2,295,865)

Income Taxes - Schedule of Comp

Income Taxes - Schedule of Components of Income Tax Expense (Benefit) (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Current tax, Federal
Current tax, State	102,677	49,000
Current tax, Foreign	9,937	1,341
Current Income Tax Expense (Benefit)	112,614	50,341
Deferred Tax, Federal	27,689	(225,347)
Deferred Tax, State	52,477	17,621
Deferred Income Tax Expense (Benefit)	80,166	(207,726)
Total income tax provision (benefit)	$ 192,780	$ (157,385)

Income Taxes - Schedule of De_2

Income Taxes - Schedule of Deferred Tax Assets and Liabilities (Details) - USD ($)	Dec. 31, 2019	Dec. 31, 2018	Dec. 31, 2017
Income Tax Disclosure [Abstract]
Allowance for doubtful accounts	$ 65,529	$ 46,492
Deferred revenue	4,807	4,664
Deferred rent		4,275
Property and intangible assets	2,301,987	2,336,221
State net operating loss ("NOL") carryforwards	910,274	636,578
Federal net operating loss ("NOL") carryforwards	4,146,274	3,789,618
Section 163(j) interest limitation	13,499	51,319
Cumulative translation adjustment	216,255	349,834
Stock based compensation	118,377	335,785
ASC 606 - Section 481(A) adjustment	(185,162)
ASC 842-ROU asset	(790,446)
ASC 842 - Lease liability	799,376
Other	18,238	(24,654)
Valuation allowance	(7,154,510)	(7,176,391)	$ (6,620,464)
Total deferred tax assets	464,498	353,741
Deferred tax liabilities:
Goodwill amortization	(709,010)	(518,087)
Net deferred tax liability	$ (244,512)	$ (164,346)

Income Taxes - Schedule of Effe

Income Taxes - Schedule of Effective Income Tax Rate Reconciliation (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Income Tax Disclosure [Abstract]
Federal benefit at statutory rate	$ (142,594)	$ (482,132)
Increase (decrease) in income taxes resulting from:
State tax expense, net of federal benefit	142,079	29,646
Non-deductible items	24,883	15,332
Impact of foreign operations	31,408	(525,583)
Subpart F GILTI inclusion	69,862	360,742
Deferred true-up	332,792	(142,869)
Valuation allowance	(304,009)	555,927
Additional tax goodwill/contingent consideration	38,359	31,553
Total income tax provision (benefit)	$ 192,780	$ (157,385)

Other (Expense) Income - Net -

Other (Expense) Income - Net - Schedule of Other (Expense) Income - Net (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Other Income and Expenses [Abstract]
Foreign exchange (loss) gain	$ (827,121)	$ 434,806
Other income	201,446	59,526
Other (expense) income - net	$ (625,675)	$ 494,332

Segment Reporting (Details Narr

Segment Reporting (Details Narrative)	12 Months Ended
	Dec. 31, 2019Segment
Segment Reporting [Abstract]
Number of operating segment	2

Segment Reporting - Schedule of

Segment Reporting - Schedule of Revenues, Operating Expenses and Operating Income (Loss) by Reportable Segment (Details) - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Net revenue	$ 64,438,594	$ 50,545,781
Direct operating costs	41,186,024	31,252,535
Selling and marketing	1,521,815	1,611,982
General and administrative	17,911,797	16,264,473
Research and development	870,780	1,029,510
Change in contingent consideration	(343,768)	73,271
Depreciation and amortization	3,005,606	2,853,827
Restructuring and impairment charges	219,013
Total operating expenses	64,371,267	53,085,598
Operating income (loss)	67,327	(2,539,817)
Healthcare IT [Member]
Net revenue	51,171,508	44,044,700
Direct operating costs	30,798,404	26,289,770
Selling and marketing	1,487,196	1,593,052
General and administrative	11,124,271	9,834,749
Research and development	870,780	1,029,510
Change in contingent consideration	(343,768)	73,271
Depreciation and amortization	2,689,240	2,700,577
Restructuring and impairment charges	219,013
Total operating expenses	46,845,136	41,520,929
Operating income (loss)	4,326,372	2,523,771
Practice Management [Member]
Net revenue	13,267,086	6,501,081
Direct operating costs	10,387,620	4,962,765
Selling and marketing	34,619	18,930
General and administrative	2,066,522	1,164,505
Research and development
Change in contingent consideration
Depreciation and amortization	316,366	153,250
Restructuring and impairment charges
Total operating expenses	12,805,127	6,299,450
Operating income (loss)	461,959	201,631
Unallocated Corporate Expenses [Member]
Net revenue
Direct operating costs
Selling and marketing
General and administrative	4,721,004	5,265,219
Research and development
Change in contingent consideration
Depreciation and amortization
Restructuring and impairment charges
Total operating expenses	4,721,004	5,265,219
Operating income (loss)	$ (4,721,004)	$ (5,265,219)

Fair Value of Financial Instr_3

Fair Value of Financial Instruments (Details Narrative)	Dec. 31, 2018USD ($)
Fair Value, Input, Level 3 [Member]
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Contingent consideration	$ 526,000

Fair Value of Financial Instr_4

Fair Value of Financial Instruments - Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation (Details) - Fair Value, Input, Level 3 [Member] - USD ($)	12 Months Ended
	Dec. 31, 2019	Dec. 31, 2018
Fair Value, Liabilities Measured on Recurring Basis, Unobservable Input Reconciliation [Line Items]
Balance, beginning	$ 526,432	$ 603,411
Change in fair value	(343,768)	73,271
Payments	(182,664)	(150,250)
Balance, ending		$ 526,432

Subsequent Event (Details Narra

Subsequent Event (Details Narrative) - USD ($)	Jan. 08, 2020	Dec. 31, 2019	Dec. 31, 2018
Preferred Stock [Member]
Number of shres issued		373,000
Warrants [Member]
Warrants to purchase			2,353,489
Subsequent Event [Member] | Merger Agreement [Member]
Cash	$ 11,900,000
Working capital deficiency	$ 5,100,000
Revenues earn-out payment, description	The Merger Agreement provides that if CareCloud's 2020 revenues exceed $36 million, there will be an earn-out payment to the seller equal to such excess, up to $3 million.
Shares held in escrow	160,000
Shares held in escrow, term	24 months
Additional shares held in escrow	100,000
Additional shares held in escrow, term	18 months
Subsequent Event [Member] | Merger Agreement [Member] | Preferred Stock [Member]
Number of shres issued	760,000
Subsequent Event [Member] | Merger Agreement [Member] | Warrants [Member]
Warrants to purchase	2,000,000
Subsequent Event [Member] | Merger Agreement [Member] | Common Stock [Member]
Warrants to purchase	1,000,000
Warrants exercise price	$ 7.50
Warrants term	2 years
Subsequent Event [Member] | Merger Agreement [Member] | Other Warrants [Member]
Warrants to purchase	1,000,000
Warrants exercise price	$ 10
Warrants term	3 years