CareCloud (CCLD) 10-Q 4 Nov 21 2021 Q3 Quarterly report Financial data

Cover

Cover - shares	9 Months Ended
	Sep. 30, 2021	Oct. 29, 2021
Document Information [Line Items]
Document Type	10-Q
Amendment Flag	false
Document Quarterly Report	true
Document Transition Report	false
Document Period End Date	Sep. 30, 2021
Document Fiscal Period Focus	Q3
Document Fiscal Year Focus	2021
Current Fiscal Year End Date	--12-31
Entity File Number	001-36529
Entity Registrant Name	CareCloud, Inc.
Entity Central Index Key	0001582982
Entity Tax Identification Number	22-3832302
Entity Incorporation, State or Country Code	DE
Entity Address, Address Line One	7 Clyde Road
Entity Address, City or Town	Somerset
Entity Address, State or Province	NJ
Entity Address, Postal Zip Code	08873
City Area Code	(732)
Local Phone Number	873-5133
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Non-accelerated Filer
Entity Small Business	true
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		14,874,631
Common Stock [Member]
Document Information [Line Items]
Title of 12(b) Security	Common Stock, par value $0.001 per share
Trading Symbol	MTBC
Security Exchange Name	NASDAQ
11% Series A Cumulative Redeemable Perpetual Preferred Stock [Member]
Document Information [Line Items]
Title of 12(b) Security	11% Series A Cumulative Redeemable Perpetual Preferred Stock, par value $0.001 per share
Trading Symbol	MTBCP
Security Exchange Name	NASDAQ

Condensed Consolidated Balance

Condensed Consolidated Balance Sheets - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Current assets:
Cash		$ 20,925
Restricted cash
Accounts receivable - net, of allowance for doubtful accounts of $369 and $522 at September 30, 2021 and December 31, 2020, respectively		12,089
Contract asset		4,105
Inventory		399
Current assets - related party		13
Prepaid expenses and other current assets		7,288
Total current assets		44,819
Property and equipment - net		4,921
Operating lease right-of-use assets	$ 7,108	7,743
Intangible assets - net		29,978
Goodwill		49,291
Other assets		1,247
TOTAL ASSETS		137,999
Current liabilities:
Accounts payable		6,461
Accrued compensation		2,590
Accrued expenses		8,501
Operating lease liability (current portion)	3,929	4,729
Deferred revenue (current portion)		1,173
Accrued liability to related party		1
Deferred payroll taxes		927
Notes payable (current portion)		401
Dividend payable		4,241
Consideration payable
Total current liabilities		29,024
Notes payable		41
Contingent consideration
Borrowings under line of credit
Deferred payroll taxes		927
Operating lease liability	5,026	6,297
Deferred revenue		305
Deferred tax liability		160
Total liabilities		36,754
COMMITMENTS AND CONTINGENCIES (NOTE 8)
SHAREHOLDERS’ EQUITY:
Preferred stock, $0.001 par value - authorized 7,000,000 shares at September 30, 2021 and December 31, 2020; issued and outstanding 5,295,414 and 5,475,279 shares at September 30, 2021 and December 31, 2020, respectively		5
Common stock, $0.001 par value - authorized 29,000,000 shares at September 30, 2021 and December 31, 2020; issued 15,614,210 and 14,121,044 shares at September 30, 2021 and December 31, 2020, respectively; 14,873,411 and 13,380,245 shares outstanding at September 30, 2021 and December 31, 2020, respectively		14
Additional paid-in capital		136,781
Accumulated deficit		(33,889)
Accumulated other comprehensive loss		(1,004)
Less: 740,799 common shares held in treasury, at cost at September 30, 2021 and December 31, 2020		(662)
Total shareholders’ equity	97,051	101,245
TOTAL LIABILITIES AND SHAREHOLDERS’ EQUITY		$ 137,999
Unaudited
Current assets:
Cash	8,313
Restricted cash	1,000
Accounts receivable - net, of allowance for doubtful accounts of $369 and $522 at September 30, 2021 and December 31, 2020, respectively	18,094
Contract asset	4,661
Inventory	500
Current assets - related party	13
Prepaid expenses and other current assets	3,817
Total current assets	36,398
Property and equipment - net	5,108
Operating lease right-of-use assets	7,108
Intangible assets - net	32,143
Goodwill	60,661
Other assets	1,091
TOTAL ASSETS	142,509
Current liabilities:
Accounts payable	5,803
Accrued compensation	3,390
Accrued expenses	5,894
Operating lease liability (current portion)	3,929
Deferred revenue (current portion)	1,089
Accrued liability to related party
Deferred payroll taxes	927
Notes payable (current portion)	590
Dividend payable	3,843
Consideration payable	1,000
Total current liabilities	26,465
Notes payable	24
Contingent consideration	6,500
Borrowings under line of credit	6,000
Deferred payroll taxes	927
Operating lease liability	5,026
Deferred revenue	216
Deferred tax liability	300
Total liabilities	45,458
COMMITMENTS AND CONTINGENCIES (NOTE 8)
SHAREHOLDERS’ EQUITY:
Preferred stock, $0.001 par value - authorized 7,000,000 shares at September 30, 2021 and December 31, 2020; issued and outstanding 5,295,414 and 5,475,279 shares at September 30, 2021 and December 31, 2020, respectively	5
Common stock, $0.001 par value - authorized 29,000,000 shares at September 30, 2021 and December 31, 2020; issued 15,614,210 and 14,121,044 shares at September 30, 2021 and December 31, 2020, respectively; 14,873,411 and 13,380,245 shares outstanding at September 30, 2021 and December 31, 2020, respectively	16
Additional paid-in capital	133,806
Accumulated deficit	(34,575)
Accumulated other comprehensive loss	(1,539)
Less: 740,799 common shares held in treasury, at cost at September 30, 2021 and December 31, 2020	(662)
Total shareholders’ equity	97,051
TOTAL LIABILITIES AND SHAREHOLDERS’ EQUITY	$ 142,509

Condensed Consolidated Balanc_2

Condensed Consolidated Balance Sheets (Parenthetical) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Allowance for doubtful accounts receivable		$ 522
Preferred stock, par value		$ 0.001
Preferred stock, shares authorized		7,000,000
Preferred stock, shares issued		5,475,279
Preferred stock, shares outstanding		5,475,279
Common stock, par value		$ 0.001
Common stock, shares authorized		29,000,000
Common stock, shares issued		14,121,044
Common stock, shares outstanding		13,380,245
Treasury stock, shares		740,799
Unaudited
Allowance for doubtful accounts receivable	$ 369
Preferred stock, par value	$ 0.001
Preferred stock, shares authorized	7,000,000
Preferred stock, shares issued	5,295,414
Preferred stock, shares outstanding	5,295,414
Common stock, par value	$ 0.001
Common stock, shares authorized	29,000,000
Common stock, shares issued	15,614,210
Common stock, shares outstanding	14,873,411
Treasury stock, shares	740,799

Condensed Consolidated Statemen

Condensed Consolidated Statements of Operations (Unaudited) - USD ($)		3 Months Ended		9 Months Ended
		Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Income Statement [Abstract]
NET REVENUE		$ 38,304,000	$ 31,639,000	$ 102,137,000	$ 73,085,000
OPERATING EXPENSES:
Direct operating costs		24,124,000	19,718,000	62,719,000	45,842,000
Selling and marketing		2,375,000	1,571,000	6,469,000	4,778,000
General and administrative		5,921,000	6,191,000	17,814,000	17,176,000
Research and development		488,000	2,367,000	4,328,000	6,846,000
Change in contingent consideration			(500,000)		(500,000)
Depreciation and amortization		3,547,000	3,206,000	9,505,000	6,944,000
Loss on lease termination, impairment and unoccupied lease charges		424,000	321,000	1,664,000	681,000
Total operating expenses		36,879,000	32,874,000	102,499,000	81,767,000
OPERATING INCOME (LOSS)		1,425,000	(1,235,000)	(362,000)	(8,682,000)
OTHER:
Interest income		4,000	2,000	10,000	44,000
Interest expense		(91,000)	(132,000)	(274,000)	(396,000)
Other (expense) income - net		(65,000)	(246,000)	(80,000)	84,000
INCOME (LOSS) BEFORE PROVISION FOR INCOME TAXES		1,273,000	(1,611,000)	(706,000)	(8,950,000)
Income tax (benefit) provision		(232,000)	62,000	(20,000)	18,000
NET INCOME (LOSS)		1,505,000	(1,673,000)	(686,000)	(8,968,000)
Preferred stock dividend		3,642,000	4,230,000	10,408,000	10,150,000
NET LOSS ATTRIBUTABLE TO COMMON SHAREHOLDERS		$ (2,137,000)	$ (5,903,000)	$ (11,094,000)	$ (19,118,000)
Net loss per common share: basic and diluted		$ (0.15)	$ (0.46)	$ (0.77)	$ (1.53)
Weighted-average common shares used to compute basic and diluted loss per share		14,737,103	12,771,307	14,419,968	12,493,458
NET INCOME (LOSS)		$ 1,505,000	$ (1,673,000)	$ (686,000)	$ (8,968,000)
OTHER COMPREHENSIVE INCOME (LOSS), NET OF TAX
Foreign currency translation adjustment (a)	[1]	(475,000)	282,000	(535,000)	(292,000)
COMPREHENSIVE INCOME (LOSS)		$ 1,030,000	$ (1,391,000)	$ (1,221,000)	$ (9,260,000)
[1]	No tax effect has been recorded as the Company recorded a valuation allowance against the tax benefit from its foreign currency translation adjustments.

Condensed Consolidated Statem_2

Condensed Consolidated Statements of Shareholders' Equity (Unaudited) - USD ($) $ in Thousands		Preferred Stock [Member]	Common Stock [Member]	Additional Paid-in Capital [Member]	Retained Earnings [Member]	AOCI Attributable to Parent [Member]	Treasury Stock [Member]	Total
Balance at Dec. 31, 2019		$ 2	$ 13	$ 69,403	$ (25,075)	$ (843)	$ (662)	$ 42,838
Balance, shares at Dec. 31, 2019		2,539,325	12,978,485
Net loss					(2,502)			(2,502)
Foreign currency translation adjustment						(590)		(590)
Issuance of stock under the equity incentive plan
Issuance of stock under the Amended and Restated Equity Incentive Plan, shares		28,870	129,607
Issuance of preferred stock in connection with the Meridian acquisition		$ 1		18,999				19,000
Issuance of preferred stock in connection with an acquisition, shares		760,000
Issuance of warrants in connection with the Meridian acquisition				300				300
Stock-based compensation, net of cash settlements				794				794
Preferred stock dividends				(2,643)				(2,643)
Balance at Mar. 31, 2020		$ 3	$ 13	86,853	(27,577)	(1,433)	(662)	57,197
Balance, shares at Mar. 31, 2020		3,328,195	13,108,092
Balance at Dec. 31, 2019		$ 2	$ 13	69,403	(25,075)	(843)	(662)	42,838
Balance, shares at Dec. 31, 2019		2,539,325	12,978,485
Net loss								(8,968)
Foreign currency translation adjustment	[1]							(292)
Preferred stock dividends								(10,150)
Balance at Sep. 30, 2020		$ 5	$ 13	138,156	(34,042)	(1,135)	(662)	102,335
Balance, shares at Sep. 30, 2020		5,470,473	13,876,887
Balance at Mar. 31, 2020		$ 3	$ 13	86,853	(27,577)	(1,433)	(662)	57,197
Balance, shares at Mar. 31, 2020		3,328,195	13,108,092
Net loss					(4,792)			(4,792)
Foreign currency translation adjustment						16		16
Issuance of preferred stock, net of fees and expenses		$ 1		19,013				19,014
Issuance of preferred stock, net of fees and expenses, shares		828,000
Issuance of stock under the Amended and Restated Equity Incentive Plan
Issuance of stock under the Amended and Restated Equity Incentive Plan, shares		4,803	87,398
Issuance of preferred stock in connection with the Meridian acquisition				5,000				5,000
Issuance of preferred stock in connection with an acquisition, shares		200,000
Issuance of warrants in connection with the Meridian acquisition				4,770				4,770
Stock-based compensation, net of cash settlements				1,439				1,439
Preferred stock dividends				(3,277)				(3,277)
Balance at Jun. 30, 2020		$ 4	$ 13	113,798	(32,369)	(1,417)	(662)	79,367
Balance, shares at Jun. 30, 2020		4,360,998	13,195,490
Net loss					(1,673)			(1,673)
Foreign currency translation adjustment						282		282	[1]
Issuance of preferred stock, net of fees and expenses		$ 1		25,529				25,530
Issuance of preferred stock, net of fees and expenses, shares		1,104,000
Issuance of stock under the Amended and Restated Equity Incentive Plan
Issuance of stock under the Amended and Restated Equity Incentive Plan, shares		5,475	282,048
Release of preferred stock from escrow				(1,392)				(1,392)
Stock-based compensation, net of cash settlements				1,456				1,456
Exercise of common stock warrants				2,995				2,995
Exercise of common stock warrants, shares			399,349
Preferred stock dividends				(4,230)				(4,230)
Balance at Sep. 30, 2020		$ 5	$ 13	138,156	(34,042)	(1,135)	(662)	102,335
Balance, shares at Sep. 30, 2020		5,470,473	13,876,887
Balance at Dec. 31, 2020		$ 5	$ 14	136,781	(33,889)	(1,004)	(662)	101,245
Balance, shares at Dec. 31, 2020		5,475,279	14,121,044
Net loss					(1,964)			(1,964)
Foreign currency translation adjustment						345		345
Issuance of stock under the equity incentive plan		$ 1		(1)
Issuance of stock under the Amended and Restated Equity Incentive Plan, shares		27,682	161,545
Stock-based compensation, net of cash settlements				623				623
Exercise of common stock warrants			$ 1	6,391				6,392
Exercise of common stock warrants, shares			858,000
Preferred stock dividends				(3,128)				(3,128)
Balance at Mar. 31, 2021		$ 6	$ 15	140,666	(35,853)	(659)	(662)	103,513
Balance, shares at Mar. 31, 2021		5,502,961	15,140,589
Balance at Dec. 31, 2020		$ 5	$ 14	136,781	(33,889)	(1,004)	(662)	101,245
Balance, shares at Dec. 31, 2020		5,475,279	14,121,044
Net loss								(686)
Foreign currency translation adjustment	[1]							(535)
Preferred stock dividends								(10,408)
Balance at Sep. 30, 2021		$ 5	$ 16	133,806	(34,575)	(1,539)	(662)	97,051
Balance, shares at Sep. 30, 2021		5,295,414	15,614,210
Balance at Mar. 31, 2021		$ 6	$ 15	140,666	(35,853)	(659)	(662)	103,513
Balance, shares at Mar. 31, 2021		5,502,961	15,140,589
Net loss					(227)			(227)
Foreign currency translation adjustment						(405)		(405)
Issuance of preferred stock, net of fees and expenses				1,360				1,360
Issuance of preferred stock, net of fees and expenses, shares			178,092
Issuance of stock under the Amended and Restated Equity Incentive Plan
Issuance of stock under the Amended and Restated Equity Incentive Plan, shares		4,244	33,724
Cancellation of shares held in escrow		$ (1)		(4,000)				(4,001)
Cancellation of shares held in escrow, shares		(215,822)
Stock-based compensation, net of cash settlements				1,163				1,163
Preferred stock dividends				(3,638)				(3,638)
Balance at Jun. 30, 2021		$ 5	$ 15	135,551	(36,080)	(1,064)	(662)	97,765
Balance, shares at Jun. 30, 2021		5,291,383	15,352,405
Net loss					1,505			1,505
Foreign currency translation adjustment						(475)		(475)	[1]
Issuance of preferred stock, net of fees and expenses			$ 1	1,168				1,169
Issuance of preferred stock, net of fees and expenses, shares			136,395
Issuance of stock under the Amended and Restated Equity Incentive Plan
Issuance of stock under the Amended and Restated Equity Incentive Plan, shares		4,031	125,410
Stock-based compensation, net of cash settlements				729				729
Preferred stock dividends				(3,642)				(3,642)
Balance at Sep. 30, 2021		$ 5	$ 16	$ 133,806	$ (34,575)	$ (1,539)	$ (662)	$ 97,051
Balance, shares at Sep. 30, 2021		5,295,414	15,614,210
[1]	No tax effect has been recorded as the Company recorded a valuation allowance against the tax benefit from its foreign currency translation adjustments.

Condensed Consolidated Statem_3

Condensed Consolidated Statements of Cash Flows (Unaudited) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
OPERATING ACTIVITIES:
Net loss	$ (686)	$ (8,968)
Adjustments to reconcile net loss to net cash provided by (used in) operating activities:
Depreciation and amortization	9,853	6,816
Lease amortization	2,191	2,134
Deferred revenue	(193)	160
Provision for doubtful accounts	465	296
Provision (benefit) for deferred income taxes	140	(93)
Foreign exchange gain	(87)	(63)
Interest accretion	599	511
Gain on sale of assets		(2)
Stock-based compensation expense	4,006	4,951
Change in contingent consideration		(500)
Adjustment of goodwill	36
Changes in operating assets and liabilities, net of businesses acquired:
Accounts receivable	(1,363)	(1,209)
Contract asset	(556)	(274)
Inventory	(101)	186
Other assets	(135)	106
Accounts payable and other liabilities	(6,959)	(8,384)
Net cash provided by (used in) operating activities	7,210	(4,333)
INVESTING  ACTIVITIES:
Purchase of property and equipment	(1,992)	(1,289)
Capitalized software	(5,277)	(3,767)
Cash paid for acquisitions (net)	(12,582)	(23,716)
Net cash used in investing activities	(19,851)	(28,772)
FINANCING  ACTIVITIES:
Preferred stock dividends paid	(10,806)	(7,798)
Settlement of tax withholding obligations on stock issued to employees	(2,096)	(1,847)
Repayments of notes payable, net	(745)	(430)
Proceeds from exercise of warrants	6,391	2,995
Proceeds from issuance of common stock, net of expenses	2,528
Proceeds from line of credit	11,000	19,500
Repayment from line of credit	(5,000)	(19,500)
Settlement of contingent obligation		(1,325)
Net proceeds from issuance of preferred stock		44,544
Net cash provided by financing activities	1,272	36,139
EFFECT OF EXCHANGE RATE CHANGES ON CASH	(243)	(188)
NET (DECREASE) INCREASE IN CASH	(11,612)	2,846
CASH - beginning of the period	20,925	19,994
CASH AND RESTRICTED CASH - end of the period	9,313	22,840
SUPPLEMENTAL NONCASH INVESTING AND FINANCING ACTIVITIES:
Preferred stock (cancelled) issued in connection with an acquisition	(4,000)	24,000
Contingent consideration	6,500
Vehicle financing obtained		28
Dividends declared, not paid	3,843	4,097
Purchase of prepaid insurance with assumption of note	967	668
Warrants issued		5,070
SUPPLEMENTAL INFORMATION - Cash paid during the period for:
Income taxes	237	64
Interest	$ 55	$ 150

ORGANIZATION AND BUSINESS

ORGANIZATION AND BUSINESS	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
ORGANIZATION AND BUSINESS	1. ORGANIZATION AND BUSINESS CareCloud, Inc., formerly MTBC, Inc. (“CareCloud”, and together with its consolidated subsidiaries, the “Company,” “we,” “us” and/or “our”) is a healthcare information technology company that provides a full suite of proprietary cloud-based solutions, together with related business services, to healthcare providers and hospitals throughout the United States. 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. Our Software-as-a-Service (“SaaS”) platform includes revenue cycle management (“RCM”), practice management (“PM”), electronic health record (“EHR”), business intelligence, telehealth, patient experience management (“PXM”) solutions and complementary software tools and business services for high-performance medical groups and health systems. CareCloud has its corporate offices in Somerset, New Jersey and maintains client support teams throughout the U.S., and offshore offices in Pakistan and Azad Jammu and Kashmir, a region administered by Pakistan (the “Pakistan Offices”), and in Sri Lanka. CareCloud was founded in 1999 under the name Medical Transcription Billing, Corp. and incorporated under the laws of the State of Delaware in 2001. In 2004, the Company formed MTBC Private Limited (or “MTBC Pvt. Ltd.”), a 99.9 0.01 In January 2020, the Company purchased CareCloud Corporation, a company whose name we took. That company is now known as CareCloud Health, Inc. (“CCH”). In June 2020, the Company purchased Meridian Billing Management Co. and its affiliate Origin Holdings, Inc. (collectively “Meridian” and sometimes referred to as “Meridian Medical Management”). During March 2021, the Company formed a new wholly-owned subsidiary, CareCloud Acquisition, Corp. (“CAC”). In June 2021, CAC purchased certain assets and assumed certain liabilities of MedMatica Consulting Associates Inc., (“MedMatica”) and purchased the stock of Santa Rosa Staffing, Inc., (“SRS”). The assets and liabilities of MedMatica were merged into SRS and the company was renamed medSR, Inc. (“medSR”). See Note 3. During 2020, a New Jersey corporation, talkMD Clinicians, PA (“talkMD”), was formed by the wife of the Executive Chairman, who is a licensed physician, to provide telehealth services. talkMD was determined to be a variable interest entity (“VIE”) for financial reporting purposes because the entity will be controlled by the Company. As of September 30, 2021, talkMD had not yet commenced operations. During September 2021, the Company made arrangements to have the income tax returns prepared for talkMD and will advance the funds for the required taxes. The aggregate amount to be advanced is approximately $ 3,500

BASIS OF PRESENTATION

BASIS OF PRESENTATION	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
BASIS OF PRESENTATION	2. BASIS OF PRESENTATION The accompanying unaudited condensed consolidated financial statements have been prepared in accordance with accounting principles generally accepted in the United States of America (“GAAP”) for interim financial reporting and as required by Regulation S-X, Rule 8-03. Accordingly, they do not include all of the information and notes required by GAAP for complete financial statements. In the opinion of the Company’s management, the accompanying unaudited condensed consolidated financial statements contain all adjustments (consisting of items of a normal and recurring nature) necessary to present fairly the Company’s financial position as of September 30, 2021, the results of operations for the three months and nine months ended September 30, 2021 and 2020 and cash flows for the nine months ended September 30, 2021 and 2020. When preparing financial statements in conformity with GAAP, the Company must make estimates and assumptions that affect the reported amounts of assets and liabilities, disclosure of contingent assets and liabilities at the date of the financial statements and the reported amounts of revenues and expenses during the reporting period. Actual results could differ significantly from those estimates. The condensed consolidated balance sheet as of December 31, 2020 was derived from our audited consolidated financial statements. The accompanying unaudited condensed consolidated financial statements and notes thereto should be read in conjunction with the audited consolidated financial statements for the year ended December 31, 2020, which are included in the Company’s Annual Report on Form 10-K, filed with the SEC on February 25, 2021. Recent Accounting Pronouncements Simplifying the Accounting for Income Taxes In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40). In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses: Measurement of Credit Losses on Financial Instruments.

ACQUISITIONS

ACQUISITIONS	9 Months Ended
	Sep. 30, 2021
Business Combination and Asset Acquisition [Abstract]
ACQUISITIONS	3. ACQUISITIONS 2021 Acquisition On June 1, 2021, CAC entered into an Asset and Stock Purchase Agreement (“Purchase Agreement”) with MedMatica and its sole shareholder. Pursuant to the Purchase Agreement, CAC acquired (i) all of the issued and outstanding capital stock of SRS, a Delaware corporation, and (ii) all of the MedMatica assets that were used in MedMatica’s and SRS’ business. Certain MedMatica liabilities were also assumed under the Purchase Agreement. The total cash consideration was $ 10 3.8 8 5 MedMatica and SRS are in the business of providing a broad range of specialty consulting services to hospitals and large healthcare groups, including certain consulting services related to healthcare IT application services and implementations, medical practice management, and revenue cycle management. The acquisition has been accounted for as a business combination. A summary of the total consideration is as follows: SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION medSR Purchase Price ($ in thousands) Cash $ 12,261 Amounts held in escrow 1,571 Contingent consideration 6,500 Preferred stock Warrants Total purchase price $ 20,332 The Company engaged a third party valuation specialist to assist the Company in valuing the assets acquired and liabilities assumed from MedMatica. The following table summarizes the preliminary purchase price allocation. The Company expects to finalize the purchase price allocation during the fourth quarter of 2021 and is finalizing the projections and the valuation of the acquired assets and assumed liabilities. The preliminary purchase price allocation for medSR is summarized as follows: SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED ($ in thousands) Accounts receivable $ 2,705 Receivable from seller 396 Prepaid expenses 108 Unbilled receivables 2,402 Property and equipment 94 Customer relationships 4,500 Acquired backlog 500 Goodwill 11,406 Accounts payable (536 ) Accrued expenses & compensation (1,223 ) Deferred revenue (20 ) Total preliminary purchase price allocation $ 20,332 The acquired accounts receivable is recorded at fair value, which represents amounts that have subsequently been paid or were 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 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 goodwill from this acquisition is deductible ratably for income tax purposes over fifteen years. The purchase agreement provides that if revenue and EBITDA over the next 18 months exceeds certain specified amounts, there will be an earn-out payment to the seller equal to such excess, up to $13 million. It was estimated that the probable payment will be approximately $ 6.5 million and this amount has been recorded as part of the preliminary purchase price allocation as contingent consideration. As part of the acquisition, $ 1.5 million of the purchase price was held in escrow, which represents $ 500,000 to be paid upon the achievement of agreed upon achievement of certain revenue and backlog milestones, and the balance will be held up to 18 months to satisfy certain indemnification obligations. During the current quarter, the initial portion of the escrow was settled whereby $ 250,000 was paid to the seller and $ 250,000 was offset against the working capital adjustment. The balance of the $ 1.0 million escrow is included in consideration payable and restricted cash in the condensed consolidated balance sheet at September 30, 2021. Approximately $ 12.3 million in cash was paid at closing. The weighted-average amortization period of the acquired intangible assets is approximately three years Revenue earned from the clients obtained from the medSR acquisition on June 1, 2021 was approximately $ 6.3 9.0 The medSR 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 expansion of its customer base and by increasing available customer relationship resources and specialized trained staff. 2020 Acquisitions On June 16, 2020, the Company entered into a Stock Purchase Agreement with Meridian Billing Management Co., a Vermont corporation, Origin Holdings, Inc., a Delaware corporation, and GMM II Holdings, LLC, a Delaware limited liability company (“Seller”), pursuant to which the Company purchased all of the issued and outstanding capital stock of Meridian from the Seller. Meridian is in the business of providing medical billing, revenue cycle management, electronic medical records, medical coding and related services. These revenues have been included in the Company’s Healthcare IT segment. The acquisition has been accounted for as a business combination. The total consideration paid at closing was $ 11.9 200,000 2,250,000 7.50 two years 4.8 A summary of the total consideration is as follows: SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION Meridian Purchase Price ($ in thousands) Cash $ 11,864 Preferred stock 5,000 Warrants 4,770 Total purchase price $ 21,634 Of the Preferred Stock consideration, 100,000 The Company’s Preferred Stock and warrants issued as part of the acquisition consideration were issued in a transaction exempt from registration under the Securities Act of 1933, as amended (the “Securities Act”). The warrants were valued using the Black-Scholes method. The Company registered the Preferred Stock and the securities underlying the warrants for resale under the Securities Act. The Meridian 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 Company engaged a third-party valuation specialist to assist the Company in valuing the assets acquired and liabilities assumed from Meridian. The following table summarizes the purchase price allocation: SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED ($ in thousands) Accounts receivable $ 3,558 Prepaid expenses 704 Contract asset 881 Property and equipment 426 Operating lease right-of-use assets 2,776 Customer relationships 12,900 Technology 900 Goodwill 13,789 Accounts payable (3,373 ) Accrued expenses & compensation (3,932 ) Deferred revenue (907 ) Operating lease liabilities (6,025 ) Other current liabilities (63 ) Total purchase price allocation $ 21,634 The acquired accounts receivable is recorded at fair value, which represents amounts that have subsequently been paid or were 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 not deductible for income tax purposes 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 from the clients obtained from the Meridian acquisition was approximately $ 9.4 28.1 10.0 11.4 On January 8, 2020, the Company entered into an Agreement and Plan of Merger (the “Merger Agreement”) with CareCloud Corporation, a Delaware corporation which was subsequently renamed CareCloud Health, Inc. (“CCH”), 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 CCH (the “Merger”), with CCH surviving as a wholly-owned subsidiary of the Company. The Merger became effective simultaneously with the execution of the Merger Agreement. The acquisition has been accounted for as a business combination. The total consideration for the Merger included approximately $ 11.9 5.1 760,000 The Merger Agreement provided that if CCH’s 2020 revenues exceed $36 million, there will be an earn-out payment to the seller equal to such excess, up to $3 million. 2,000,000 1,000,000 7.50 two years 1,000,000 10.00 three years A summary of the total consideration is as follows: SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION CCH Purchase Price ($ in thousands) Cash $ 11,853 Preferred stock 19,000 Warrants 300 Contingent consideration 1,000 Total purchase price $ 32,153 Of the Preferred Stock consideration, 160,000 24 100,000 18 513,000 160,000 It was determined that 55,822 1.3 102,000 The Company’s Preferred Stock and warrants 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 warrants were valued using the Black-Scholes method. The Company registered the Preferred Stock and the securities underlying the warrants for resale under the Securities Act. The CCH acquisition added additional clients to the Company’s customer base. The Company acquired CCH’s software technology and related business. Similar to previous acquisitions, this transaction 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 Company engaged a third-party valuation specialist to assist the Company in valuing the assets acquired and liabilities assumed from CCH. The following table summarizes the purchase price allocation: SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED ($ in thousands) Accounts receivable $ 2,299 Prepaid expenses 1,278 Contract asset 538 Property and equipment 403 Operating lease right-of-use assets 2,859 Customer relationships 8,000 Trademark 800 Software 4,800 Goodwill 22,868 Other long term assets 540 Accounts payable (6,943 ) Accrued expenses (2,081 ) Current loan payable (80 ) Operating lease liabilities (2,859 ) Deferred revenue (269 ) Total purchase price allocation $ 32,153 The acquired accounts receivable is recorded at fair value, which represents amounts that have subsequently been paid or were 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 not deductible for income tax purposes 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 from the clients obtained from the CCH acquisition was approximately $ 8.8 26.0 8.2 23.2 Pro forma financial information (Unaudited) The unaudited pro forma information below represents the condensed consolidated results of operations as if the CCH, Meridian and medSR acquisitions occurred on January 1, 2020. The pro forma information has been included for comparative purposes and is not indicative of results of operations that the Company would have had if the acquisitions occurred on the above date, nor is it necessarily indicative of future results. The unaudited pro forma information reflects material, non-recurring pro forma adjustments directly attributable to the business combinations. The difference between the actual revenue and the pro forma revenue is approximately $ 17.8 million of additional revenue primarily recorded by medSR for the nine months ended September 30, 2021. Other differences arise from amortizing purchased intangibles using the double declining balance method. SCHEDULE OF BUSINESS ACQUISITION, PRO FORMA INFORMATION 2021 2020 2021 2020 Three Months Ended Nine Months Ended 2021 2020 2021 2020 ($ in thousands except per share amounts) Total revenue $ 38,304 $ 35,051 $ 119,929 $ 101,318 Net income (loss) $ 2,211 $ (1,112 ) $ 1,593 $ (12,823 ) Net loss attributable to common shareholders $ (1,431 ) $ (5,434 ) $ (8,815 ) $ (23,680 ) Net loss per common share $ (0.10 ) $ (0.43 ) $ (0.61 ) $ (1.90 )

GOODWILL AND INTANGIBLE ASSETS-

GOODWILL AND INTANGIBLE ASSETS-NET	9 Months Ended
	Sep. 30, 2021
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 nine months ended September 30, 2021 and the year ended December 31, 2020: SCHEDULE OF INTANGIBLE ASSETS AND GOODWILL Nine Months Ended Year Ended September 30, 2021 December 31, 2020 ($ in thousands) Beginning gross balance $ 49,291 $ 12,634 Acquisitions 11,370 36,657 Ending gross balance $ 60,661 $ 49,291 Intangible assets include customer contracts and relationships and covenants not-to-compete acquired in connection with acquisitions, as well as trademarks acquired and software costs. Intangible assets - net as of September 30, 2021 and December 31, 2020 consist of the following: SCHEDULE OF FINITE-LIVED INTANGIBLE ASSETS September 30, 2021 December 31, 2020 ($ in thousands) Contracts and relationships acquired $ 48,997 $ 44,497 Capitalized software 10,976 5,760 Non-compete agreements 1,236 1,236 Other intangible assets 8,355 7,906 Total intangible assets 69,564 59,399 Less: Accumulated amortization 37,421 29,421 Intangible assets - net $ 32,143 $ 29,978 Amortization expense was approximately $ 8.0 million and $ 6.0 million for the nine months ended September 30, 2021 and 2020, respectively, and $ 3.1 million and $ 2.8 million for the three months ended September 30, 2021 and 2020, respectively. The remaining weighted-average amortization period is approximately 3.1 years. As of September 30, 2021, future amortization scheduled to be expensed is as follows: SCHEDULE OF FINITE-LIVED INTANGIBLE ASSETS, FUTURE AMORTIZATION EXPENSE Years ending December 31, ($ in thousands) 2021 (three months) $ 3,731 2022 12,586 2023 9,574 2024 4,601 2025 300 Thereafter 1,351 Total $ 32,143

NET LOSS PER COMMON SHARE

NET LOSS PER COMMON SHARE	9 Months Ended
	Sep. 30, 2021
Earnings Per Share [Abstract]
NET LOSS PER COMMON SHARE	5. NET LOSS PER COMMON SHARE The following table reconciles the weighted-average shares outstanding for basic and diluted net loss per share for the three and nine months ended September 30, 2021 and 2020: SCHEDULE OF LOSSES PER SHARE, BASIC AND DILUTED 2021 2020 2021 2020 Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 ($ in thousands, except share and per share amounts) Basic and Diluted: Net loss attributable to common shareholders $ (2,137 ) $ (5,903 ) $ (11,094 ) $ (19,118 ) Weighted-average common shares used to compute basic and diluted loss per share 14,737,103 12,771,307 14,419,968 12,493,458 Net loss attributable to common shareholders per share - Basic and Diluted $ (0.15 ) $ (0.46 ) $ (0.77 ) $ (1.53 ) All unvested restricted stock units (“RSUs”) and unexercised warrants have been excluded from the above calculations as they were anti-dilutive. Vested RSUs, vested restricted shares and exercised warrants have been included in the above calculations.

DEBT

DEBT	9 Months Ended
	Sep. 30, 2021
Debt Disclosure [Abstract]
DEBT	6. DEBT SVB 200 10 20 6.0 1.50 6.5 1 The debt is secured by all of the Company’s domestic assets and 65% of the shares in its offshore facilities. Future acquisitions are subject to approval by SVB. Vehicle Financing Notes The Company financed certain vehicle purchases both in the United States and in Pakistan. The vehicle financing notes have three to six year terms and were issued at current market rates. Insurance Financing 4.15

LEASES

LEASES	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
LEASES	7. LEASES We determine if an arrangement is a lease at inception. We have operating leases for office and temporary living space as well as for some office equipment. Operating leases are included in operating lease right-of-use (“ROU”) assets, current operating lease liability and non-current operating lease liability in our condensed consolidated balance sheets as of September 30, 2021 and December 31, 2020. Each time the Company acquires a business, the ROU assets and the lease liabilities are recorded at fair value as of the date of acquisition. 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. As most of our leases do not provide an implicit rate, we use our estimated incremental borrowing rates, based on information available at the lease commencement date, in determining the present value of lease payments. We give consideration to our bank financing arrangements, geographical location and collateralization of assets when calculating our incremental borrowing rates. Our lease terms typically include options to extend the lease. We consider the options in determining the ROU assets and lease liabilities. Leases with a term of less than 12 months are not recorded in the condensed consolidated balance sheets. 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 are re-measured using the current incremental borrowing rate. During the nine months ended September 30, 2021, there was $ 686,000 300,000 383,000 In February 2021, the Company was able to settle one of the lease obligations assumed in connection with the Meridian acquisition for an amount that approximated the remaining lease liability. During the current quarter, the Company decided to terminate one of its leases in Pakistan which, with a modification, will expire as of the end of the year. The Company does not intend to renew this lease and will consolidate its employees into the remaining facilities. As a result of the termination, the Company incurred a loss of approximately $ 18,000 which has been included in loss on lease termination, impairment and unoccupied lease charges in the September 30, 2021 condensed consolidated statement of operations. Lease expense is included in direct operating costs and general and administrative expenses in the condensed consolidated statements of operations based on the nature of the expense. As of September 30, 2021, we had 37 leased properties, six in Medical Practice Management and 31 in Healthcare IT, with remaining terms ranging from less than one year five years The components of lease expense were as follows: SCHEDULE OF LEASE EXPENSE 2021 2020 2021 2020 Three Months Ended Nine Months Ended 2021 2020 2021 2020 ($ in thousands) Operating lease cost $ 1,066 $ 1,227 $ 3,181 $ 2,861 Short-term lease cost 22 25 65 36 Variable lease cost 11 7 25 22 Total- net lease cost $ 1,099 $ 1,259 $ 3,271 $ 2,919 Short-term lease cost represents leases that were not capitalized as the lease term as of the later of January 1, 2021 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 is as follows: SCHEDULE OF SUPPLEMENTAL BALANCE SHEET INFORMATION RELATED TO LEASES 1 2 September 30, 2021 December 31, 2020 ($ in thousands) Operating leases: Operating lease ROU assets, net $ 7,108 $ 7,743 Current operating lease liabilities $ 3,929 $ 4,729 Non-current operating lease liabilities 5,026 6,297 Total operating lease liabilities $ 8,955 $ 11,026 Operating leases: ROU assets $ 9,310 $ 10,648 Asset lease expense (2,191 ) (2,889 ) Foreign exchange gain (loss) (11 ) (16 ) ROU assets, net $ 7,108 $ 7,743 Weighted average remaining lease term (in years): Operating leases 4.41 2.71 Weighted average discount rate: Operating leases 6.78 % 6.76 % Supplemental cash flow and other information related to leases is as follows: SCHEDULE OF SUPPLEMENTAL CASH FLOW AND OTHER INFORMATION RELATED TO LEASES 2021 2020 2021 2020 Three Months Ended Nine Months Ended 2021 2020 2021 2020 ($ in thousands) Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 1,316 $ 1,417 $ 4,048 $ 2,860 ROU assets obtained in exchange for lease liabilities: Operating leases, net of impairment and terminations $ 315 $ 203 $ 2,063 $ 6,467 Maturities of lease liabilities are as follows: SCHEDULE OF MATURITIES OF LEASE LIABILITIES 5 Operating leases - Year ending December 31, ($ in thousands) 2021 (three months) $ 1,253 2022 4,115 2023 2,024 2024 789 2025 481 Thereafter 1,972 Total lease payments 10,634 Less: imputed interest (1,679 ) Total lease obligations 8,955 Less: current obligations (3,929 ) Long-term lease obligations $ 5,026 As of September 30, 2021, we have one operating lease commitment that has not yet commenced with an aggregate gross lease liability of approximately $ 99,000

COMMITMENTS AND CONTINGENCIES

COMMITMENTS AND CONTINGENCIES	9 Months Ended
	Sep. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
COMMITMENTS AND CONTINGENCIES	8. COMMITMENTS AND CONTINGENCIES Legal Proceedings On April 23, 2019, the Appellate Division reversed the Chancery Court’s ruling that CareCloud 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 completed discovery in the remanded matter, and both CareCloud 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 CareCloud’s motion for summary judgment, holding that CareCloud cannot be compelled to participate in the Arbitration. RPRWC has informed CareCloud 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. On March 25, 2020, the Chancery Court lifted the stay of arbitration relative to RPRWC and MAC. Due to conflicting information provided by RPRWC, it is unclear what the extent of the claimed damages are in this matter which at this time appear to be entirely speculative. According to its arbitration demand, RPRWC seeks compensatory damages of $6.6 million, plus costs, for MPMA’s alleged breach of the billing services agreement. 6.6 20 11 From time to time, we may become involved in other legal proceedings arising in the ordinary course of our business. Including the proceedings 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.

RELATED PARTIES

RELATED PARTIES	9 Months Ended
	Sep. 30, 2021
Related Party Transactions [Abstract]
RELATED PARTIES	9. 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 $ 15,000 11,000 6,000 4,000 2,000 The Company was a party to a nonexclusive aircraft dry lease agreement with Kashmir Air, Inc. (“KAI”), which is owned by the Executive Chairman. The Company recorded an expense of approximately $ 80,000 105,000 20,000 32,000 1,000 185,000 The Company leases its corporate offices in New Jersey, its temporary housing for its foreign visitors, a printing and mailing facility and its backup operations center in Bagh, Pakistan, from the Executive Chairman. The related party rent expense for the nine months ended September 30, 2021 and 2020 was approximately $ 140,000 and $ 139,000 , respectively, and the rent expense was approximately $ 47,000 for both the three months ended September 30, 2021 and 2020, respectively, and is included in direct operating costs and general and administrative expense in the condensed consolidated statements of operations. During the nine months ended September 30, 2021, the Company spent approximately $ 1.4 million to upgrade the related party leased facilities and the leased aircraft. Current assets-related party in the condensed consolidated balance sheets includes security deposits and prepaid rent related to the leases of the Company’s corporate offices in the amount of approximately $ 13,000 as of both September 30, 2021 and December 31, 2020. On October 15, 2021, the Company entered into a one-year lease agreement with the Executive Chairman for an apartment for temporary housing in Dubai. Included in ROU assets at September 30, 2021 and December 31, 2020 is approximately $ 119,000 283,000 61,000 57,000 202,000 92,000 During 2020, a New Jersey corporation, talkMD Clinicians, PA (“talkMD”), was formed by the wife of the Executive Chairman, who is a licensed physician, to provide telehealth services. talkMD was determined to be a variable interest entity (“VIE”) for financial reporting purposes because the entity will be controlled by the Company. As of September 30, 2021, talkMD had not yet commenced operations. During September 2021, the Company made arrangements to have the income tax returns prepared for talkMD and will advance the funds for the required taxes. The aggregate amount to be advanced is approximately $ 3,500

SHAREHOLDERS_ EQUITY

SHAREHOLDERS’ EQUITY	9 Months Ended
	Sep. 30, 2021
Equity [Abstract]
SHAREHOLDERS’ EQUITY	10. SHAREHOLDERS’ EQUITY The Company has the right to sell up to $ 50 3 178,092 1.4 136,395 1.2 215,822

REVENUE

REVENUE	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
REVENUE	11. REVENUE Introduction The Company accounts for revenue in accordance with ASC 606, Revenue from Contracts with Customers Many technology-enabled business solutions are invoiced based on receipt of payment by the practices which are our clients, for medical billing claims where the provider utilized our software or where we submitted a claim. For these solutions, the Company estimates the value of the consideration it will earn over the remaining contractual period as our services are provided and recognizes the fees over the term; this estimation involves predicting the amounts our clients will ultimately collect from the services they provided. The selling price of the Company’s services equals the contractual price. Certain significant estimates, such as payment-to-charge ratios, effective billing rates and the estimated contractual payment periods are required to measure revenue under ASC 606. 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 the majority of our revenue from providing technology-enabled business solutions, including our integrated SaaS-based software platform and revenue cycle management services. In addition, we derive revenues from professional services, group purchasing services, printing and mailing services, and medical practice management services. The following table represents a disaggregation of revenue for the three and nine months ended September 30: SCHEDULE OF DISAGGREGATION OF REVENUE Three Months Ended Nine Months Ended 2021 2020 2021 2020 ($ in thousands) Healthcare IT: Technology-enabled business solutions $ 27,086 $ 27,078 $ 80,075 $ 61,138 Professional services 6,863 489 10,978 1,278 Printing and mailing services 429 341 1,084 1,094 Group purchasing services 300 283 659 649 Medical Practice Management: Medical practice management services 3,626 3,448 9,341 8,926 Total $ 38,304 $ 31,639 $ 102,137 $ 73,085 Technology-enabled business solutions: Most of our revenue comes from clients who are using subscription-based technology-enabled business solutions. These solutions typically include one or more elements of our proprietary cloud-based software-as-a-service (“SaaS”) platform, along with revenue cycle management and related services. Practice management software automates the labor-intensive workflow of a medical office in a unified and streamlined manner. EHR software allows our healthcare provider clients to deliver better patient care, document their clinical visits effectively and to potentially qualify for government incentives, reduce documentation errors and reduce paperwork. Patient experience management software allows patients to schedule appointments, request refills, and view their electronic records online or via their mobile device. Business intelligence, robotic process automation, patient experience software, customized applications, interfaces and a variety of other technology solutions support our healthcare clients, either in conjunction with our practice management and EHR platform or through interfaces with third-party platforms. When these software elements are part of the technology-enabled business solution, they are normally included in a price, which is normally expressed as a percentage of the practice’s collections. 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. Approximately 78 22 The Company invoices many customers on a monthly basis based on the actual collections received by customers and the agreed-upon rate in the sales contract. The fee for these services typically includes use of practice management software and related tools (on a SaaS basis), electronic health records (on a SaaS basis), medical billing services and use of mobile health solutions. Alternatively, SaaS fees may be fixed based on the number of providers, or may be variable based on usage. 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 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. Included in technology-enabled business solutions are ancillary services such as coding, credentialing and transcription that are rendered in connection with the delivery of revenue cycle management and related services. The Company invoices customers monthly, based on the actual amount of services performed at the agreed upon rate in the contract. These services are only offered to 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 ancillary service transaction processed represents a performance obligation, which is satisfied over time as that individual service is rendered. Also included in technology-enabled business solutions are medical billing clearinghouse services that takes claim information from customers, checks the claims for errors and sends this information electronically to insurance companies. The Company 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. Professional services: The Company provides implementation and professional services to certain customers and records revenue monthly on a time and materials or a fixed rate basis. These services consist of implementation, advisory and on demand staffing. This is a separate performance obligation from any revenue cycle management and SaaS services provided, for which the Company receives and records monthly fees. The performance obligation is satisfied over time as the professional services are rendered. Substantially all of the professional 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. Other revenue streams The Company provides printing and mailing services for both technology-enabled business solutions and a customer that does not utilize our technology-enabled business solutions, 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 Company also provides group purchasing services that enable medical providers to purchase various vaccines directly from selected pharmaceutical companies at a discounted price. Currently, there are approximately 4,000 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 that 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. For all of the above revenue streams other than group purchasing services and printing and mailing, 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. Medical practice management services: The Company also provides medical 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 the 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 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 medical 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 condensed consolidated statements of operations. Our medical 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, the management fee is computed at each month end. Information about contract balances: The contract assets in the condensed consolidated balance sheets represent the revenue associated with the amounts we estimate our clients will ultimately collect if our charges are based on a percentage of collections, together with amounts related to the group purchasing services. As of September 30, 2021, the estimated revenue expected to be recognized in the future related to the remaining performance obligations outstanding was approximately $ 4.1 544,000 Accounts receivable are shown separately at their net realizable value in our condensed consolidated balance sheets. Amounts that we are entitled to collect under the applicable contract are recorded as accounts receivable. Invoicing is performed at the end of each month when the services have been provided. The contract asset results from our revenue cycle management services and is due to the timing of revenue recognition, submission of claims from our customers and payments from the insurance providers. The contract asset includes our right to payment for services already transferred to a customer when the right to payment is conditional on something other than the passage of time. For example, contracts for 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. The contract asset was approximately $ 4.7 4.1 SCHEDULE OF ACCOUNTS RECEIVABLE, CONTRACT ASSET AND DEFERRED REVENUE Accounts Receivable, Net Contract Asset Deferred Revenue (current) Deferred Revenue ($ in thousands) Balance as of January 1, 2021 $ 12,089 $ 4,105 $ 1,173 $ 305 medSR acquisition 2,705 2,402 20 - Meridian acquisition - - - - Increase (decrease), net 3,300 (1,846 ) (104 ) (89 ) Balance as of September 30, 2021 $ 18,094 $ 4,661 $ 1,089 $ 216 Balance as of January 1, 2020 $ 6,995 $ 2,385 $ 20 $ 19 CCH acquisition 2,299 538 - 269 Meridian acquisition 3,558 881 907 - Increase (decrease), net 913 274 288 (128 ) Balance as of September 30, 2020 $ 13,765 $ 4,078 $ 1,215 $ 160 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 for contracts entered into by CCH. Deferred commissions were approximately $ 922,000 870,000

STOCK-BASED COMPENSATION

STOCK-BASED COMPENSATION	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement [Abstract]
STOCK-BASED COMPENSATION	12. STOCK-BASED COMPENSATION In April 2014, the Company adopted the Medical Transcription Billing, Corp. 2014 Equity Incentive Plan (the “2014 Plan”), reserving 1,351,000 1,500,000 100,000 200,000 2,000,000 300,000 1,344,833 323,878 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 share per RSU, immediately after a change in control, as defined in the award agreement. The preferred stock RSUs contain a similar provision, which vest and convert to Preferred Stock upon a change in control. Common and preferred stock RSUs In January 2021, the Compensation Committee approved executive bonuses to be paid in shares of Preferred Stock, with the number of shares and the amount based on specified criteria being achieved during the year 2021. The actual amount will be settled in early 2022 based on the achievement of the specified criteria. For the nine months ended September 30, 2021, an expense of approximately $ 749,000 The following table summarizes the RSU transactions related to the common and preferred stock under the Equity Incentive Plan for the nine months ended September 30, 2021 and 2020: DISCLOSURE OF SHARE-BASED COMPENSATION ARRANGEMENTS BY SHARE-BASED PAYMENT AWARD Common Stock Preferred Stock Outstanding and unvested shares at January 1, 2021 382,435 44,000 Granted 458,467 46,197 Vested (475,120 ) (56,197 ) Forfeited (85,286 ) - Outstanding and unvested shares at September 30, 2021 280,496 34,000 Outstanding and unvested shares at January 1, 2020 451,085 44,000 Granted 777,884 59,673 Vested (667,436 ) (59,673 ) Forfeited (82,428 ) - Outstanding and unvested shares at September 30, 2020 479,105 44,000 The total outstanding and unvested common stock RSUs at September 30, 2021 are classified as equity. 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 and includes the related taxes. For stock awards classified as a liability, the earned amount is marked to market based on the end of period common stock price. The liability for the cash-settled awards was approximately $ 559,000 976,000 The following table summarizes the components of share-based compensation expense for the three months and nine months ended September 30, 2021 and 2020: SCHEDULE OF EMPLOYEE SERVICE SHARE-BASED COMPENSATION, ALLOCATION OF RECOGNIZED PERIOD COSTS Stock-based compensation included in the condensed consolidated statements of operations: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 ($ in thousands) Direct operating costs $ 207 $ 379 $ 766 $ 809 General and administrative 737 819 2,482 2,887 Research and development (3 ) 262 206 516 Selling and marketing 63 303 552 739 Total stock-based compensation expense $ 1,004 $ 1,763 $ 4,006 $ 4,951

INCOME TAXES

INCOME TAXES	9 Months Ended
	Sep. 30, 2021
Income Tax Disclosure [Abstract]
INCOME TAXES	13. INCOME TAXES The income tax benefit for the three months ended September 30, 2021 was approximately $ 232,000 comprised of a current tax benefit of $ 245,000 and a deferred tax expense of $ 13,000 . The Company filed a carryback claim for approximately $ 285,000 with the Internal Revenue Service to recover taxes previously paid by Meridian prior to its acquisition of Meridian. The income tax benefit for the nine months ended September 30, 2021 was approximately $ 20,000 , comprised of a current tax benefit of $ 160,000 and a deferred tax expense of $ 140,000 . The deferred tax expense is not anticipated to result in a cash payment. The carryback claim receivable is recorded in prepaid expenses and other current assets in the condensed consolidated balance sheet at September 30, 2021. With the exception of the carryback claim tax benefit mentioned above, the current income tax provision for the nine months ended September 30, 2021 and 2020 primarily relates to state minimum taxes and foreign income taxes. The deferred tax provision for the three and nine months ended September 30, 2021 and 2020 relates to the book and tax difference of amortization on indefinite-lived intangibles, primarily goodwill. To the extent allowable, the federal deferred tax provision has been offset by the indefinite life net operating loss. On March 27, 2020, the Coronavirus Aid, Relief and Economic Security (CARES) Act was signed into law. Several new corporate tax provisions were included in the CARES Act, including, but not limited to, the following: increasing the limitation threshold for determining deductible interest expense, class life changes to qualified improvements (in general - from 39 years 15 years the ability to carry back net operating losses incurred from tax years 2018 through 2020 up to the five preceding tax years. 1.9 The Company has 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 the Federal and state deferred tax assets as of September 30, 2021 and December 31, 2020.

FAIR VALUE OF FINANCIAL INSTRUM

FAIR VALUE OF FINANCIAL INSTRUMENTS	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
FAIR VALUE OF FINANCIAL INSTRUMENTS	14. FAIR VALUE OF FINANCIAL INSTRUMENTS Fair value measurements are based upon observable and unobservable inputs. Observable inputs reflect market data obtained from independent sources, while unobservable inputs reflect our view of market participant assumptions in the absence of observable market information. We utilize valuation techniques that maximize the use of observable inputs and minimize the use of unobservable inputs. The fair values of assets and liabilities required to be measured at fair value are categorized based upon the level of judgement associated with the inputs used to measure their value in one of the following three categories: Level 1: Inputs are unadjusted quoted prices in active markets for identical assets or liabilities. We held no Level 1 financial instruments at September 30, 2021 or December 31, 2020. Level 2: Quoted prices for similar instruments in active markets with inputs that are observable, either directly or indirectly. Our Level 2 financial instruments include notes payable which are carried at cost and approximate fair value since the interest rates being charged approximate market rates. Level 3: Unobservable inputs are significant to the fair value of the asset or liability, and include situations where there is little, if any, market activity for the asset or liability. Our Level 3 instrument includes the fair value of contingent consideration related to completed acquisitions. The fair value at September 30, 2020 is based on a discounted cash flow analysis reflecting the likelihood of achieving specified performance measure or events and captures the contractual nature of the contingencies, the passage of time and the associated discount rate. As of September 30, 2021, the contingent consideration is valued using a Monte Carlo simulation model. 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): SCHEDULE OF FAIR VALUE, LIABILITIES MEASURED ON RECURRING BASIS, UNOBSERVABLE INPUT RECONCILIATION Fair Value Measurement at Reporting Date Using Significant Unobservable Inputs, Level 3 Nine Months Ended 2021 2020 ($ in thousands) Balance - January 1, $ - $ - Acquisitions 6,500 1,000 Change in fair value - (500 ) Payments - - Balance - September 30, $ 6,500 $ 500

SEGMENT REPORTING

SEGMENT REPORTING	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
SEGMENT REPORTING	15. SEGMENT REPORTING The Company’s Chief Executive Officer and Executive Chairman jointly serve as the Chief Operating Decision Maker (“CODM”), organize the Company, manage resource allocations and measure performance among two The Healthcare IT segment includes revenue cycle management, SaaS solutions and other services. The Medical 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, that 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 Company’s Annual Report on Form 10-K for the year ended December 31, 2020 filed with the SEC on February 25, 2021. The following tables present revenues, operating expenses and operating (loss) income by reportable segment: SCHEDULE OF REVENUES, OPERATING EXPENSES AND OPERATING INCOME (LOSS) BY REPORTABLE SEGMENT Nine Months Ended September 30, 2021 ($ in thousands) Healthcare IT Medical Practice Management Unallocated Corporate Expenses Total Net revenue $ 92,797 $ 9,340 $ - $ 102,137 Operating expenses: Direct operating costs 55,473 7,246 - 62,719 Selling and marketing 6,446 23 - 6,469 General and administrative 10,175 1,487 6,152 17,814 Research and development 4,328 - - 4,328 Change in contingent consideration - - - - Depreciation and amortization 9,251 254 - 9,505 Loss on lease termination, impairment and unoccupied lease charges 1,664 - - 1,664 Total operating expenses 87,337 9,010 6,152 102,499 Operating income (loss) $ 5,460 $ 330 $ (6,152 ) $ (362 ) Three Months Ended September 30, 2021 ($ in thousands) Healthcare IT Medical Practice Management Unallocated Corporate Expenses Total Net revenue $ 34,678 $ 3,626 $ - $ 38,304 Operating expenses: Direct operating costs 21,324 2,800 - 24,124 Selling and marketing 2,368 7 - 2,375 General and administrative 3,336 471 2,114 5,921 Research and development 488 - - 488 Depreciation and amortization 3,459 88 - 3,547 Loss on lease termination, impairment and unoccupied lease charges 424 - - 424 Total operating expenses 31,399 3,366 2,114 36,879 Operating income (loss) $ 3,279 $ 260 $ (2,114 ) $ 1,425 Nine Months Ended September 30, 2020 ($ in thousands) Healthcare IT Medical Practice Management Unallocated Corporate Expenses Total Net revenue $ 64,159 $ 8,926 $ - $ 73,085 Operating expenses: Direct operating costs 39,074 6,768 - 45,842 Selling and marketing 4,753 25 - 4,778 General and administrative 11,067 1,493 4,616 17,176 Research and development 6,846 - - 6,846 Change in contingent consideration (500 ) - - (500 ) Depreciation and amortization 6,706 238 - 6,944 Impairment charges 681 - - 681 Total operating expenses 68,627 8,524 4,616 81,767 Operating (loss) income $ (4,468 ) $ 402 $ (4,616 ) $ (8,682 ) Three Months Ended September 30, 2020 ($ in thousands) Healthcare IT Medical Practice Management Unallocated Corporate Expenses Total Net revenue $ 28,191 $ 3,448 $ - $ 31,639 Operating expenses: Direct operating costs 17,147 2,571 - 19,718 Selling and marketing 1,563 8 - 1,571 General and administrative 4,173 468 1,550 6,191 Research and development 2,367 - - 2,367 Change in contingent consideration (500 ) - - (500 ) Depreciation and amortization 3,127 79 - 3,206 Impairment charges 321 - - 321 Total operating expenses 28,198 3,126 1,550 32,874 Operating (loss) income $ (7 ) $ 322 $ (1,550 ) $ (1,235 )

BASIS OF PRESENTATION (Policies

BASIS OF PRESENTATION (Policies)	9 Months Ended
	Sep. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Recent Accounting Pronouncements	Recent Accounting Pronouncements Simplifying the Accounting for Income Taxes In August 2020, the FASB issued ASU 2020-06, Debt—Debt with Conversion and Other Options (Subtopic 470-20) and Derivatives and Hedging—Contracts in Entity’s Own Equity (Subtopic 815-40). In June 2016, the FASB issued ASU 2016-13, Financial Instruments – Credit Losses: Measurement of Credit Losses on Financial Instruments.

ACQUISITIONS (Tables)

ACQUISITIONS (Tables)	9 Months Ended
	Sep. 30, 2021
Asset Acquisition [Line Items]
SCHEDULE OF BUSINESS ACQUISITION, PRO FORMA INFORMATION	SCHEDULE OF BUSINESS ACQUISITION, PRO FORMA INFORMATION 2021 2020 2021 2020 Three Months Ended Nine Months Ended 2021 2020 2021 2020 ($ in thousands except per share amounts) Total revenue $ 38,304 $ 35,051 $ 119,929 $ 101,318 Net income (loss) $ 2,211 $ (1,112 ) $ 1,593 $ (12,823 ) Net loss attributable to common shareholders $ (1,431 ) $ (5,434 ) $ (8,815 ) $ (23,680 ) Net loss per common share $ (0.10 ) $ (0.43 ) $ (0.61 ) $ (1.90 )
Acqisition 2021 [Member] | Meridian Billing Management Co [Member]
Asset Acquisition [Line Items]
SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION	A summary of the total consideration is as follows: SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION medSR Purchase Price ($ in thousands) Cash $ 12,261 Amounts held in escrow 1,571 Contingent consideration 6,500 Preferred stock Warrants Total purchase price $ 20,332
SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED	The preliminary purchase price allocation for medSR is summarized as follows: SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED ($ in thousands) Accounts receivable $ 2,705 Receivable from seller 396 Prepaid expenses 108 Unbilled receivables 2,402 Property and equipment 94 Customer relationships 4,500 Acquired backlog 500 Goodwill 11,406 Accounts payable (536 ) Accrued expenses & compensation (1,223 ) Deferred revenue (20 ) Total preliminary purchase price allocation $ 20,332
Acqisition 2020 [Member] | Meridian Billing Management Co [Member]
Asset Acquisition [Line Items]
SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION	A summary of the total consideration is as follows: SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION Meridian Purchase Price ($ in thousands) Cash $ 11,864 Preferred stock 5,000 Warrants 4,770 Total purchase price $ 21,634
SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED	SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED ($ in thousands) Accounts receivable $ 3,558 Prepaid expenses 704 Contract asset 881 Property and equipment 426 Operating lease right-of-use assets 2,776 Customer relationships 12,900 Technology 900 Goodwill 13,789 Accounts payable (3,373 ) Accrued expenses & compensation (3,932 ) Deferred revenue (907 ) Operating lease liabilities (6,025 ) Other current liabilities (63 ) Total purchase price allocation $ 21,634
Acqisition 2020 [Member] | Care Cloud Health Inc [Member]
Asset Acquisition [Line Items]
SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION	A summary of the total consideration is as follows: SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION CCH Purchase Price ($ in thousands) Cash $ 11,853 Preferred stock 19,000 Warrants 300 Contingent consideration 1,000 Total purchase price $ 32,153
SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED	SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED ($ in thousands) Accounts receivable $ 2,299 Prepaid expenses 1,278 Contract asset 538 Property and equipment 403 Operating lease right-of-use assets 2,859 Customer relationships 8,000 Trademark 800 Software 4,800 Goodwill 22,868 Other long term assets 540 Accounts payable (6,943 ) Accrued expenses (2,081 ) Current loan payable (80 ) Operating lease liabilities (2,859 ) Deferred revenue (269 ) Total purchase price allocation $ 32,153

GOODWILL AND INTANGIBLE ASSET_2

GOODWILL AND INTANGIBLE ASSETS-NET (Tables)	9 Months Ended
	Sep. 30, 2021
Goodwill and Intangible Assets Disclosure [Abstract]
SCHEDULE OF INTANGIBLE ASSETS AND GOODWILL	SCHEDULE OF INTANGIBLE ASSETS AND GOODWILL Nine Months Ended Year Ended September 30, 2021 December 31, 2020 ($ in thousands) Beginning gross balance $ 49,291 $ 12,634 Acquisitions 11,370 36,657 Ending gross balance $ 60,661 $ 49,291
SCHEDULE OF FINITE-LIVED INTANGIBLE ASSETS	SCHEDULE OF FINITE-LIVED INTANGIBLE ASSETS September 30, 2021 December 31, 2020 ($ in thousands) Contracts and relationships acquired $ 48,997 $ 44,497 Capitalized software 10,976 5,760 Non-compete agreements 1,236 1,236 Other intangible assets 8,355 7,906 Total intangible assets 69,564 59,399 Less: Accumulated amortization 37,421 29,421 Intangible assets - net $ 32,143 $ 29,978
SCHEDULE OF FINITE-LIVED INTANGIBLE ASSETS, FUTURE AMORTIZATION EXPENSE	As of September 30, 2021, future amortization scheduled to be expensed is as follows: SCHEDULE OF FINITE-LIVED INTANGIBLE ASSETS, FUTURE AMORTIZATION EXPENSE Years ending December 31, ($ in thousands) 2021 (three months) $ 3,731 2022 12,586 2023 9,574 2024 4,601 2025 300 Thereafter 1,351 Total $ 32,143

NET LOSS PER COMMON SHARE (Tabl

NET LOSS PER COMMON SHARE (Tables)	9 Months Ended
	Sep. 30, 2021
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 share for the three and nine months ended September 30, 2021 and 2020: SCHEDULE OF LOSSES PER SHARE, BASIC AND DILUTED 2021 2020 2021 2020 Three Months Ended Nine Months Ended September 30, September 30, 2021 2020 2021 2020 ($ in thousands, except share and per share amounts) Basic and Diluted: Net loss attributable to common shareholders $ (2,137 ) $ (5,903 ) $ (11,094 ) $ (19,118 ) Weighted-average common shares used to compute basic and diluted loss per share 14,737,103 12,771,307 14,419,968 12,493,458 Net loss attributable to common shareholders per share - Basic and Diluted $ (0.15 ) $ (0.46 ) $ (0.77 ) $ (1.53 )

LEASES (Tables)

LEASES (Tables)	9 Months Ended
	Sep. 30, 2021
Leases [Abstract]
SCHEDULE OF LEASE EXPENSE	The components of lease expense were as follows: SCHEDULE OF LEASE EXPENSE 2021 2020 2021 2020 Three Months Ended Nine Months Ended 2021 2020 2021 2020 ($ in thousands) Operating lease cost $ 1,066 $ 1,227 $ 3,181 $ 2,861 Short-term lease cost 22 25 65 36 Variable lease cost 11 7 25 22 Total- net lease cost $ 1,099 $ 1,259 $ 3,271 $ 2,919
SCHEDULE OF SUPPLEMENTAL BALANCE SHEET INFORMATION RELATED TO LEASES	Supplemental balance sheet information related to leases is as follows: SCHEDULE OF SUPPLEMENTAL BALANCE SHEET INFORMATION RELATED TO LEASES 1 2 September 30, 2021 December 31, 2020 ($ in thousands) Operating leases: Operating lease ROU assets, net $ 7,108 $ 7,743 Current operating lease liabilities $ 3,929 $ 4,729 Non-current operating lease liabilities 5,026 6,297 Total operating lease liabilities $ 8,955 $ 11,026 Operating leases: ROU assets $ 9,310 $ 10,648 Asset lease expense (2,191 ) (2,889 ) Foreign exchange gain (loss) (11 ) (16 ) ROU assets, net $ 7,108 $ 7,743 Weighted average remaining lease term (in years): Operating leases 4.41 2.71 Weighted average discount rate: Operating leases 6.78 % 6.76 %
SCHEDULE OF SUPPLEMENTAL CASH FLOW AND OTHER INFORMATION RELATED TO LEASES	Supplemental cash flow and other information related to leases is as follows: SCHEDULE OF SUPPLEMENTAL CASH FLOW AND OTHER INFORMATION RELATED TO LEASES 2021 2020 2021 2020 Three Months Ended Nine Months Ended 2021 2020 2021 2020 ($ in thousands) Cash paid for amounts included in the measurement of lease liabilities: Operating cash flows from operating leases $ 1,316 $ 1,417 $ 4,048 $ 2,860 ROU assets obtained in exchange for lease liabilities: Operating leases, net of impairment and terminations $ 315 $ 203 $ 2,063 $ 6,467
SCHEDULE OF MATURITIES OF LEASE LIABILITIES	Maturities of lease liabilities are as follows: SCHEDULE OF MATURITIES OF LEASE LIABILITIES 5 Operating leases - Year ending December 31, ($ in thousands) 2021 (three months) $ 1,253 2022 4,115 2023 2,024 2024 789 2025 481 Thereafter 1,972 Total lease payments 10,634 Less: imputed interest (1,679 ) Total lease obligations 8,955 Less: current obligations (3,929 ) Long-term lease obligations $ 5,026

REVENUE (Tables)

REVENUE (Tables)	9 Months Ended
	Sep. 30, 2021
Revenue from Contract with Customer [Abstract]
SCHEDULE OF DISAGGREGATION OF REVENUE	The following table represents a disaggregation of revenue for the three and nine months ended September 30: SCHEDULE OF DISAGGREGATION OF REVENUE Three Months Ended Nine Months Ended 2021 2020 2021 2020 ($ in thousands) Healthcare IT: Technology-enabled business solutions $ 27,086 $ 27,078 $ 80,075 $ 61,138 Professional services 6,863 489 10,978 1,278 Printing and mailing services 429 341 1,084 1,094 Group purchasing services 300 283 659 649 Medical Practice Management: Medical practice management services 3,626 3,448 9,341 8,926 Total $ 38,304 $ 31,639 $ 102,137 $ 73,085
SCHEDULE OF ACCOUNTS RECEIVABLE, CONTRACT ASSET AND DEFERRED REVENUE	SCHEDULE OF ACCOUNTS RECEIVABLE, CONTRACT ASSET AND DEFERRED REVENUE Accounts Receivable, Net Contract Asset Deferred Revenue (current) Deferred Revenue ($ in thousands) Balance as of January 1, 2021 $ 12,089 $ 4,105 $ 1,173 $ 305 medSR acquisition 2,705 2,402 20 - Meridian acquisition - - - - Increase (decrease), net 3,300 (1,846 ) (104 ) (89 ) Balance as of September 30, 2021 $ 18,094 $ 4,661 $ 1,089 $ 216 Balance as of January 1, 2020 $ 6,995 $ 2,385 $ 20 $ 19 CCH acquisition 2,299 538 - 269 Meridian acquisition 3,558 881 907 - Increase (decrease), net 913 274 288 (128 ) Balance as of September 30, 2020 $ 13,765 $ 4,078 $ 1,215 $ 160

STOCK-BASED COMPENSATION (Table

STOCK-BASED COMPENSATION (Tables)	9 Months Ended
	Sep. 30, 2021
Share-based Payment Arrangement [Abstract]
DISCLOSURE OF SHARE-BASED COMPENSATION ARRANGEMENTS BY SHARE-BASED PAYMENT AWARD	The following table summarizes the RSU transactions related to the common and preferred stock under the Equity Incentive Plan for the nine months ended September 30, 2021 and 2020: DISCLOSURE OF SHARE-BASED COMPENSATION ARRANGEMENTS BY SHARE-BASED PAYMENT AWARD Common Stock Preferred Stock Outstanding and unvested shares at January 1, 2021 382,435 44,000 Granted 458,467 46,197 Vested (475,120 ) (56,197 ) Forfeited (85,286 ) - Outstanding and unvested shares at September 30, 2021 280,496 34,000 Outstanding and unvested shares at January 1, 2020 451,085 44,000 Granted 777,884 59,673 Vested (667,436 ) (59,673 ) Forfeited (82,428 ) - Outstanding and unvested shares at September 30, 2020 479,105 44,000
SCHEDULE OF EMPLOYEE SERVICE SHARE-BASED COMPENSATION, ALLOCATION OF RECOGNIZED PERIOD COSTS	The following table summarizes the components of share-based compensation expense for the three months and nine months ended September 30, 2021 and 2020: SCHEDULE OF EMPLOYEE SERVICE SHARE-BASED COMPENSATION, ALLOCATION OF RECOGNIZED PERIOD COSTS Stock-based compensation included in the condensed consolidated statements of operations: Three Months Ended September 30, Nine Months Ended September 30, 2021 2020 2021 2020 ($ in thousands) Direct operating costs $ 207 $ 379 $ 766 $ 809 General and administrative 737 819 2,482 2,887 Research and development (3 ) 262 206 516 Selling and marketing 63 303 552 739 Total stock-based compensation expense $ 1,004 $ 1,763 $ 4,006 $ 4,951

FAIR VALUE OF FINANCIAL INSTR_2

FAIR VALUE OF FINANCIAL INSTRUMENTS (Tables)	9 Months Ended
	Sep. 30, 2021
Fair Value Disclosures [Abstract]
SCHEDULE OF 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): SCHEDULE OF FAIR VALUE, LIABILITIES MEASURED ON RECURRING BASIS, UNOBSERVABLE INPUT RECONCILIATION Fair Value Measurement at Reporting Date Using Significant Unobservable Inputs, Level 3 Nine Months Ended 2021 2020 ($ in thousands) Balance - January 1, $ - $ - Acquisitions 6,500 1,000 Change in fair value - (500 ) Payments - - Balance - September 30, $ 6,500 $ 500

SEGMENT REPORTING (Tables)

SEGMENT REPORTING (Tables)	9 Months Ended
	Sep. 30, 2021
Segment Reporting [Abstract]
SCHEDULE OF REVENUES, OPERATING EXPENSES AND OPERATING INCOME (LOSS) BY REPORTABLE SEGMENT	SCHEDULE OF REVENUES, OPERATING EXPENSES AND OPERATING INCOME (LOSS) BY REPORTABLE SEGMENT Nine Months Ended September 30, 2021 ($ in thousands) Healthcare IT Medical Practice Management Unallocated Corporate Expenses Total Net revenue $ 92,797 $ 9,340 $ - $ 102,137 Operating expenses: Direct operating costs 55,473 7,246 - 62,719 Selling and marketing 6,446 23 - 6,469 General and administrative 10,175 1,487 6,152 17,814 Research and development 4,328 - - 4,328 Change in contingent consideration - - - - Depreciation and amortization 9,251 254 - 9,505 Loss on lease termination, impairment and unoccupied lease charges 1,664 - - 1,664 Total operating expenses 87,337 9,010 6,152 102,499 Operating income (loss) $ 5,460 $ 330 $ (6,152 ) $ (362 ) Three Months Ended September 30, 2021 ($ in thousands) Healthcare IT Medical Practice Management Unallocated Corporate Expenses Total Net revenue $ 34,678 $ 3,626 $ - $ 38,304 Operating expenses: Direct operating costs 21,324 2,800 - 24,124 Selling and marketing 2,368 7 - 2,375 General and administrative 3,336 471 2,114 5,921 Research and development 488 - - 488 Depreciation and amortization 3,459 88 - 3,547 Loss on lease termination, impairment and unoccupied lease charges 424 - - 424 Total operating expenses 31,399 3,366 2,114 36,879 Operating income (loss) $ 3,279 $ 260 $ (2,114 ) $ 1,425 Nine Months Ended September 30, 2020 ($ in thousands) Healthcare IT Medical Practice Management Unallocated Corporate Expenses Total Net revenue $ 64,159 $ 8,926 $ - $ 73,085 Operating expenses: Direct operating costs 39,074 6,768 - 45,842 Selling and marketing 4,753 25 - 4,778 General and administrative 11,067 1,493 4,616 17,176 Research and development 6,846 - - 6,846 Change in contingent consideration (500 ) - - (500 ) Depreciation and amortization 6,706 238 - 6,944 Impairment charges 681 - - 681 Total operating expenses 68,627 8,524 4,616 81,767 Operating (loss) income $ (4,468 ) $ 402 $ (4,616 ) $ (8,682 ) Three Months Ended September 30, 2020 ($ in thousands) Healthcare IT Medical Practice Management Unallocated Corporate Expenses Total Net revenue $ 28,191 $ 3,448 $ - $ 31,639 Operating expenses: Direct operating costs 17,147 2,571 - 19,718 Selling and marketing 1,563 8 - 1,571 General and administrative 4,173 468 1,550 6,191 Research and development 2,367 - - 2,367 Change in contingent consideration (500 ) - - (500 ) Depreciation and amortization 3,127 79 - 3,206 Impairment charges 321 - - 321 Total operating expenses 28,198 3,126 1,550 32,874 Operating (loss) income $ (7 ) $ 322 $ (1,550 ) $ (1,235 )

ORGANIZATION AND BUSINESS (Deta

ORGANIZATION AND BUSINESS (Details Narrative) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2004
talkMD Clinicians, PA [Member]
OrganizationConsolidationAndPresentationOfFinancialStatementsLineItems [Line Items]
Advance to related party	$ 3,500
MTBC Private Limited [Member]
OrganizationConsolidationAndPresentationOfFinancialStatementsLineItems [Line Items]
Equity method investment, ownership percentage		99.90%
MTBC Private Limited [Member] | Founder and Executive Chairman [Member]
OrganizationConsolidationAndPresentationOfFinancialStatementsLineItems [Line Items]
Equity method investment, ownership percentage		0.01%

SUMMARY OF TOTAL CONSIDERATION

SUMMARY OF TOTAL CONSIDERATION ON BUSINESS CONSIDERATION (Details) - USD ($) $ in Thousands	Jun. 01, 2021	Jun. 16, 2020	Jan. 08, 2020
Meridian Acquisition [Member] | Acqisition 2021 [Member]
Business Acquisition [Line Items]
Cash	$ 12,261
Amounts held in escrow	1,571
Contingent consideration	6,500
Total purchase price	$ 20,332
Meridian Acquisition [Member] | Acqisition 2020 [Member]
Business Acquisition [Line Items]
Cash		$ 11,864
Preferred stock		5,000
Warrants		4,770
Total purchase price		$ 21,634
Care Cloud Health Inc [Member] | Acqisition 2020 [Member]
Business Acquisition [Line Items]
Cash			$ 11,853
Contingent consideration			1,000
Preferred stock			19,000
Warrants			300
Total purchase price			$ 32,153

SCHEDULE OF ASSETS ACQUIRED AND

SCHEDULE OF ASSETS ACQUIRED AND LIABILITIES ASSUMED (Details) - USD ($) $ in Thousands	Jun. 01, 2021	Dec. 31, 2020	Jun. 16, 2020	Jan. 08, 2020
Business Acquisition [Line Items]
Goodwill		$ 49,291
Meridian Acquisition [Member] | Acqisition 2021 [Member]
Business Acquisition [Line Items]
Accounts receivable	$ 2,705
Receivable from seller	396
Prepaid expenses	108
Unbilled receivables	2,402
Property and equipment	94
Customer relationships	4,500
Acquired backlog	500
Goodwill	11,406
Accounts payable	(536)
Accrued expenses	(1,223)
Deferred revenue	(20)
Total purchase price allocation	$ 20,332
Meridian Acquisition [Member] | Acqisition 2020 [Member]
Business Acquisition [Line Items]
Accounts receivable			$ 3,558
Prepaid expenses			704
Property and equipment			426
Customer relationships			12,900
Goodwill			13,789
Accounts payable			(3,373)
Accrued expenses			(3,932)
Deferred revenue			(907)
Total purchase price allocation			21,634
Contract asset			881
Operating lease right-of-use assets			2,776
Technology			900
Operating lease liabilities			(6,025)
Other current liabilities			$ (63)
Care Cloud Health Inc [Member] | Acqisition 2020 [Member]
Business Acquisition [Line Items]
Accounts receivable				$ 2,299
Prepaid expenses				1,278
Property and equipment				403
Customer relationships				8,000
Goodwill				22,868
Accounts payable				(6,943)
Accrued expenses				(2,081)
Deferred revenue				(269)
Total purchase price allocation				32,153
Contract asset				538
Operating lease right-of-use assets				2,859
Operating lease liabilities				(2,859)
Trademark				800
Software				4,800
Other long term assets				540
Current loan payable				$ (80)

SCHEDULE OF BUSINESS ACQUISITIO

SCHEDULE OF BUSINESS ACQUISITION, PRO FORMA INFORMATION (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Business Combination and Asset Acquisition [Abstract]
Total revenue	$ 38,304	$ 35,051	$ 119,929	$ 101,318
Net income (loss)	2,211	(1,112)	1,593	(12,823)
Net loss attributable to common shareholders	$ (1,431)	$ (5,434)	$ (8,815)	$ (23,680)
Net loss per common share	$ (0.10)	$ (0.43)	$ (0.61)	$ (1.90)

ACQUISITIONS (Details Narrative

ACQUISITIONS (Details Narrative) - USD ($)

Jun. 01, 2021

Jun. 16, 2020

Jan. 08, 2020

Apr. 30, 2021

Sep. 30, 2020

Sep. 30, 2021

Jun. 30, 2021

Mar. 31, 2021

Sep. 30, 2020

Jun. 30, 2020

Mar. 31, 2020

Sep. 30, 2021

Sep. 30, 2020

Dec. 31, 2020

Business Acquisition [Line Items]

Business Combination, Contingent Consideration, Liability, Current

Accrued dividends on preferred stock (reversed)

$ 3,642,000

$ 3,638,000

$ 3,128,000

$ 4,230,000

$ 3,277,000

$ 2,643,000

$ 10,408,000

$ 10,150,000

Business Acquisition, Pro Forma Revenue

38,304,000

35,051,000

119,929,000

101,318,000

Preferred Stock [Member]

Business Acquisition [Line Items]

Accrued dividends on preferred stock (reversed)

Common Stock [Member]

Business Acquisition [Line Items]

Accrued dividends on preferred stock (reversed)

Meridian Acquisition [Member]

Business Acquisition [Line Items]

Business Combination, Separately Recognized Transactions, Revenues and Gains Recognized

9,400,000

10,000,000

28,100,000

11,400,000

Asset and Stock Purchase Agreement [Member]

Business Acquisition [Line Items]

Business Combination, Separately Recognized Transactions, Revenues and Gains Recognized

9,000,000

Care Cloud Health Inc [Member]

Business Acquisition [Line Items]

Business Combination, Separately Recognized Transactions, Revenues and Gains Recognized

8,800,000

$ 8,200,000

26,000,000

$ 23,200,000

Business Acquisition, Pro Forma Revenue

17,800,000

Care Cloud Health Inc [Member] | Other Warrants [Member]

Business Acquisition [Line Items]

Warrants and rights outstanding term

3 years

Asset and Stock Purchase Agreement [Member]

Business Acquisition [Line Items]

Working capital deficiency

$ 3,800,000

250,000

$ 250,000

Business Combination, Separately Recognized Transactions, Revenues and Gains Recognized

6,300,000

9,000,000

Asset and Stock Purchase Agreement [Member] | Maximum [Member]

Business Acquisition [Line Items]

Maximum earn-out payments based upon acheivements

8,000,000

Asset and Stock Purchase Agreement [Member] | Meridian Acquisition [Member]

Business Acquisition [Line Items]

Consideration paid

$ 10,000,000

$ 250,000

Revenues earn-out payment, description

The purchase agreement provides that if revenue and EBITDA over the next 18 months exceeds certain specified amounts, there will be an earn-out payment to the seller equal to such excess, up to $13 million.

Business Acquisitions, Purchase Price Allocation, Year of Acquisition, Net Effect on Income

$ 6,500,000

[custom:PurchasePriceHeldInEscrow]

1,500,000

[custom:PaymentsUponRevenueAndBacklogMilestones]

$ 500,000

Additional shares held in escrow, term

18 months

Business Combination, Contingent Consideration, Liability

$ 1,000,000

Business Combination, Contingent Consideration, Liability, Current

$ 12,300,000

Acquired finite lived intangible assets weighted average useful life

3 years

Asset and Stock Purchase Agreement [Member] | Meridian Acquisition [Member] | Maximum [Member]

Business Acquisition [Line Items]

Maximum earn-out payments based upon acheivements

$ 5,000,000

Stock Purchase Agreement [Member] | Preferred Stock [Member]

Business Acquisition [Line Items]

Consideration paid

$ 11,900,000

Number of shares issued

200,000

Aggregate value of Meridian's negative net working capital and certain long-term lease liabilities

$ 4,800,000

Shares held in escrow

100,000

Stock Purchase Agreement [Member] | Warrant [Member]

Business Acquisition [Line Items]

Warrants to purchase

2,250,000

Warrants exercise price

$ 7.50

Warrants and rights outstanding term

2 years

Stock Purchase Agreement [Member] | Meridian Acquisition [Member]

Business Acquisition [Line Items]

Acquired finite lived intangible assets weighted average useful life

3 years

Merger Agreement [Member]

Business Acquisition [Line Items]

Working capital deficiency

$ 5,100,000

Revenues earn-out payment, description

The Merger Agreement provided that if CCH’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 shares held in escrow, term

18 months

Shares held in escrow

160,000

160,000

Additional shares held in escrow

100,000

Accrued dividends on preferred stock (reversed)

$ 513,000

$ 102,000

Shares released from escrow

55,822

Cash payment

$ 1,300,000

Merger Agreement [Member] | Preferred Stock [Member]

Business Acquisition [Line Items]

Consideration paid

$ 11,900,000

Number of shares issued

760,000

Shares held in escrow, term

24 months

Merger Agreement [Member] | Warrant [Member]

Business Acquisition [Line Items]

Warrants to purchase

2,000,000

Merger Agreement [Member] | Common Stock [Member]

Business Acquisition [Line Items]

Warrants to purchase

1,000,000

Warrants exercise price

$ 7.50

Warrants and rights outstanding term

2 years

Merger Agreement [Member] | Other Warrants [Member]

Business Acquisition [Line Items]

Warrants to purchase

1,000,000

Warrants exercise price

$ 10

Warrants and rights outstanding term

3 years

SCHEDULE OF INTANGIBLE ASSETS A

SCHEDULE OF INTANGIBLE ASSETS AND GOODWILL (Details) - USD ($) $ in Thousands	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Beginning gross balance	$ 49,291	$ 12,634
Acquisitions	11,370	36,657
Ending gross balance	$ 60,661	$ 49,291

SCHEDULE OF FINITE-LIVED INTANG

SCHEDULE OF FINITE-LIVED INTANGIBLE ASSETS (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Finite-Lived Intangible Assets [Line Items]
Total intangible assets	$ 69,564	$ 59,399
Less: Accumulated amortization	37,421	29,421
Intangible assets - net	32,143	29,978
Contracts and Relationships Acquired [Member]
Finite-Lived Intangible Assets [Line Items]
Total intangible assets	48,997	44,497
Capitalized Software [Member]
Finite-Lived Intangible Assets [Line Items]
Total intangible assets	10,976	5,760
Noncompete Agreements [Member]
Finite-Lived Intangible Assets [Line Items]
Total intangible assets	1,236	1,236
Other Intangible Assets [Member]
Finite-Lived Intangible Assets [Line Items]
Total intangible assets	$ 8,355	$ 7,906

SCHEDULE OF FINITE-LIVED INTA_2

SCHEDULE OF FINITE-LIVED INTANGIBLE ASSETS, FUTURE AMORTIZATION EXPENSE (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
2021 (three months)	$ 3,731
2022	12,586
2023	9,574
2024	4,601
2025	300
Thereafter	1,351
Total	$ 32,143	$ 29,978

GOODWILL AND INTANGIBLE ASSET_3

GOODWILL AND INTANGIBLE ASSETS-NET (Details Narrative) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Goodwill and Intangible Assets Disclosure [Abstract]
Amortization of Intangible Assets	$ 3.1	$ 2.8	$ 8	$ 6
Finite-Lived Intangible Assets, Remaining Amortization Period				3 years 1 month 6 days

SCHEDULE OF LOSSES PER SHARE, B

SCHEDULE OF LOSSES PER SHARE, BASIC AND DILUTED (Details) - USD ($) $ / shares in Units, $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Earnings Per Share [Abstract]
Net loss attributable to common shareholders	$ (2,137)	$ (5,903)	$ (11,094)	$ (19,118)
Weighted-average common shares used to compute basic and diluted loss per share	14,737,103	12,771,307	14,419,968	12,493,458
Net loss attributable to common shareholders per share - Basic and Diluted	$ (0.15)	$ (0.46)	$ (0.77)	$ (1.53)

DEBT (Details Narrative)

DEBT (Details Narrative) - USD ($) $ in Millions	1 Months Ended	9 Months Ended
	Oct. 31, 2017	Sep. 30, 2021	Dec. 31, 2020	Sep. 30, 2018
Vehicle Financing Notes [Member]
Debt Instrument [Line Items]
Purchase of vehicles, description		The Company financed certain vehicle purchases both in the United States and in Pakistan. The vehicle financing notes have three to six year terms and were issued at current market rates.
Insurance Financing [Member]
Debt Instrument [Line Items]
Debt instrument interest rate			4.15%
SVB Credit Facility [Member]
Debt Instrument [Line Items]
Secured revolving line of credit percentage	200.00%
Borrowing credit facility		$ 6
Unused portion of credit line fee, percentage	1.00%
Revolving line of credit, collateral	The debt is secured by all of the Company’s domestic assets and 65% of the shares in its offshore facilities. Future acquisitions are subject to approval by SVB.
SVB Credit Facility [Member] | Minimum [Member]
Debt Instrument [Line Items]
Revolving line of credit, interest rate	6.50%
SVB Credit Facility [Member] | Prime Rate [Member]
Debt Instrument [Line Items]
Revolving line of credit, interest rate	1.50%
SVB Credit Facility [Member] | Old [Member]
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity				$ 10
SVB Credit Facility [Member] | New [Member]
Debt Instrument [Line Items]
Line of credit facility, maximum borrowing capacity				$ 20

SCHEDULE OF LEASE EXPENSE (Deta

SCHEDULE OF LEASE EXPENSE (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Leases [Abstract]
Operating lease cost	$ 1,066	$ 1,227	$ 3,181	$ 2,861
Short-term lease cost	22	25	65	36
Variable lease cost	11	7	25	22
Total- net lease cost	$ 1,099	$ 1,259	$ 3,271	$ 2,919

SCHEDULE OF SUPPLEMENTAL BALANC

SCHEDULE OF SUPPLEMENTAL BALANCE SHEET INFORMATION RELATED TO LEASES (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Leases [Abstract]
ROU assets, net	$ 7,108	$ 7,743
Current operating lease liabilities	3,929	4,729
Non-current operating lease liabilities	5,026	6,297
Total operating lease liabilities	8,955	11,026
ROU assets	9,310	10,648
Asset lease expense	(2,191)	(2,889)
Foreign exchange gain (loss)	$ (11)	$ (16)
Weighted average remaining lease term (in years): Operating leases	4 years 4 months 28 days	2 years 8 months 15 days
Weighted average discount rate: Operating leases	6.78%	6.76%

SCHEDULE OF SUPPLEMENTAL CASH F

SCHEDULE OF SUPPLEMENTAL CASH FLOW AND OTHER INFORMATION RELATED TO LEASES (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Leases [Abstract]
Operating cash flows from operating leases	$ 1,316	$ 1,417	$ 4,048	$ 2,860
Operating leases, net of impairment and terminations	$ 315	$ 203	$ 2,063	$ 6,467

SCHEDULE OF MATURITIES OF LEASE

SCHEDULE OF MATURITIES OF LEASE LIABILITIES (Details) - USD ($) $ in Thousands	Sep. 30, 2021	Dec. 31, 2020
Leases [Abstract]
2021 (three months)	$ 1,253
2022	4,115
2023	2,024
2024	789
2025	481
Thereafter	1,972
Total lease payments	10,634
Less: imputed interest	(1,679)
Total lease obligations	8,955	$ 11,026
Less: current obligations	(3,929)	(4,729)
Long-term lease obligations	$ 5,026	$ 6,297

LEASES (Details Narrative)

LEASES (Details Narrative) - USD ($)	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Unoccupied lease charges	$ 686,000	$ 300,000
Operating Lease, Impairment Loss		$ 383,000
Incurred loss on lease termination, impairment and unoccupied lease charges	18,000
Operating lease not yet commenced, commitment payable	$ 99,000
Minimum [Member]
Operating lease renewal term	1 year
Maximum [Member]
Operating lease renewal term	5 years

COMMITMENTS AND CONTINGENCIES (

COMMITMENTS AND CONTINGENCIES (Details Narrative) - USD ($) $ in Millions	Jul. 24, 2020	Jun. 12, 2020	Mar. 25, 2020
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	$ 11	$ 20	$ 6.6

RELATED PARTIES (Details Narrat

RELATED PARTIES (Details Narrative) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Related Party Transaction [Line Items]
Net revenue	$ 38,304,000	$ 31,639,000	$ 102,137,000	$ 73,085,000
Incurred loss on lease termination, impairment and unoccupied lease charges			18,000
Lease, Cost	1,099,000	1,259,000	3,271,000	2,919,000
Right of use asset	7,108,000		7,108,000		$ 7,743,000
Operating lease liability, current	3,929,000		3,929,000		4,729,000
Operating lease liability	5,026,000		5,026,000		6,297,000
TalkMD Clinicians [Member]
Related Party Transaction [Line Items]
Advance aggregate tax amount			3,500
Related Party Leases [Member]
Related Party Transaction [Line Items]
Right of use asset	119,000		119,000		283,000
Operating lease liability, current	61,000		61,000		202,000
Operating lease liability	57,000		57,000		92,000
Nonexclusive Aircraft Dry Lease Agreement [Member] | Kashmir Air, Inc [Member]
Related Party Transaction [Line Items]
Operating leases, rent expense	20,000	32,000	80,000	105,000
Accrued liability to related party					1,000
Incurred loss on lease termination, impairment and unoccupied lease charges			185,000
Physician [Member]
Related Party Transaction [Line Items]
Net revenue	6,000	4,000	15,000	11,000
Accounts Receivable, Related Parties, Current	2,000		2,000		2,000
Executive Chairman [Member]
Related Party Transaction [Line Items]
Operating leases, rent expense	$ 47,000	$ 47,000	140,000	$ 139,000
Lease, Cost			$ 1,400,000
[custom:SecurityDepositsAndPrepaidRent-0]					$ 13,000
Lessee, Operating Lease, Description			On October 15, 2021, the Company entered into a one-year lease agreement with the Executive Chairman for an apartment for temporary housing in Dubai.

SHAREHOLDERS_ EQUITY (Details N

SHAREHOLDERS’ EQUITY (Details Narrative) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Jun. 30, 2021	Sep. 30, 2021	Sep. 30, 2020
Offsetting Assets [Line Items]
Sale of Stock, Number of Shares Issued in Transaction	136,395	178,092
Proceeds from issuance of common stock	$ 1,200	$ 1,400	$ 2,528
CCH Acquisition [Member]
Offsetting Assets [Line Items]
Shares cancelled during period held in escrow		215,822
ATM [Member]
Offsetting Assets [Line Items]
Sale of stock, value			$ 50,000
Underwriter commission fees, percentage			3.00%

SCHEDULE OF DISAGGREGATION OF R

SCHEDULE OF DISAGGREGATION OF REVENUE (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Total	$ 38,304	$ 31,639	$ 102,137	$ 73,085
Healthcare IT [Member]
Total	34,678	28,191	92,797	64,159
Healthcare IT [Member] | Technology Enabled Business Solutions [Member]
Total	27,086	27,078	80,075	61,138
Healthcare IT [Member] | Professional Services [Member]
Total	6,863	489	10,978	1,278
Healthcare IT [Member] | Printing and Mailing Services [Member]
Total	429	341	1,084	1,094
Healthcare IT [Member] | Group Purchasing Services [Member]
Total	300	283	659	649
Medical Practice Management [Member]
Total	3,626	3,448	9,340	8,926
Medical Practice Management [Member] | Practice Management Services [Member]
Total	$ 3,626	$ 3,448	$ 9,341	$ 8,926

SCHEDULE OF ACCOUNTS RECEIVABLE

SCHEDULE OF ACCOUNTS RECEIVABLE, CONTRACT ASSET AND DEFERRED REVENUE (Details) - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Disaggregation of Revenue [Line Items]
Beginning balance	$ 44,819
Short-term Contract with Customer [Member]
Disaggregation of Revenue [Line Items]
Beginning balance	1,173	$ 20
CCH acquisition	20
Meridian acquisition		907
Increase (decrease), net	(104)	288
Ending balance	1,089	1,215
Long-term Contract with Customer [Member]
Disaggregation of Revenue [Line Items]
Beginning balance	305	19
CCH acquisition		269
Meridian acquisition
Increase (decrease), net	(89)	(128)
Ending balance	216	160
Accounts Receivable [Member]
Disaggregation of Revenue [Line Items]
Beginning balance	12,089	6,995
CCH acquisition	2,705	2,299
Meridian acquisition		3,558
Increase (decrease), net	3,300	913
Ending balance	18,094	13,765
Contract Asset [Member]
Disaggregation of Revenue [Line Items]
Beginning balance	4,105	2,385
CCH acquisition	2,402	538
Meridian acquisition		881
Increase (decrease), net	(1,846)	274
Ending balance	$ 4,661	$ 4,078

REVENUE (Details Narrative)

REVENUE (Details Narrative) - USD ($)	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Disaggregation of Revenue [Line Items]
Contract asset represents revenue earned, not paid from group purchasing services	$ 4,700,000	$ 4,100,000
Deferred commissions	922,000	$ 870,000
Revenue Cycle Management and Orion Acquisition [Member]
Disaggregation of Revenue [Line Items]
Revenue, remaining performance obligation, amount	4,100,000
Orion Acquisition [Member]
Disaggregation of Revenue [Line Items]
Contract asset represents revenue earned, not paid from group purchasing services	$ 544,000
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | Technology Platform [Member]
Disaggregation of Revenue [Line Items]
Cncentration risk percentage	78.00%
Revenue Benchmark [Member] | Customer Concentration Risk [Member] | Product and Service, Other [Member]
Disaggregation of Revenue [Line Items]
Cncentration risk percentage	22.00%

DISCLOSURE OF SHARE-BASED COMPE

DISCLOSURE OF SHARE-BASED COMPENSATION ARRANGEMENTS BY SHARE-BASED PAYMENT AWARD (Details) - Restricted Stock Units (RSUs) [Member] - shares	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Common Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding and unvested at beginning	382,435	451,085
Granted	458,467	777,884
Vested	(475,120)	(667,436)
Forfeited	(85,286)	(82,428)
Outstanding and unvested at ending	280,496	479,105
Preferred Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Outstanding and unvested at beginning	44,000	44,000
Granted	46,197	59,673
Vested	(56,197)	(59,673)
Forfeited
Outstanding and unvested at ending	34,000	44,000

SCHEDULE OF EMPLOYEE SERVICE SH

SCHEDULE OF EMPLOYEE SERVICE SHARE-BASED COMPENSATION, ALLOCATION OF RECOGNIZED PERIOD COSTS (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	$ 1,004	$ 1,763	$ 4,006	$ 4,951
Direct Operating Costs [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	207	379	766	809
General and Administrative Expense [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	737	819	2,482	2,887
Research and Development Expense [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	(3)	262	206	516
Selling and Marketing Expense [Member]
Share-based Payment Arrangement, Expensed and Capitalized, Amount [Line Items]
Total stock-based compensation expense	$ 63	$ 303	$ 552	$ 739

STOCK-BASED COMPENSATION (Detai

STOCK-BASED COMPENSATION (Details Narrative) - USD ($)	9 Months Ended	12 Months Ended
	Sep. 30, 2021	Dec. 31, 2018	Dec. 31, 2017	Dec. 31, 2020	May 31, 2020	Apr. 30, 2014
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Liability for cash settled amount	$ 559,000			$ 976,000
Accrued compensation	559,000			$ 976,000
Preferred Stock [Member] | Restricted Stock Units (RSUs) [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Recognized compensation	$ 749,000
2014 Equity Incentive Plan [Member] | Common Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Common stock capital shares reserved for future issuance					2,000,000
Number of shares available for grant	1,344,833
2014 Equity Incentive Plan [Member] | Preferred Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Preferred stock capital shares reserved for future issuance					300,000
Number of shares available for grant	323,878
2014 Equity Incentive Plan [Member] | Employees Officers Directors And Consultants [Member]
Share-based Compensation Arrangement by Share-based Payment Award [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] | Common Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares added to amended and restated equity incentive plan			1,500,000
Amended and Restated Equity Incentive Plan [Member] | Preferred Stock [Member]
Share-based Compensation Arrangement by Share-based Payment Award [Line Items]
Number of shares added to amended and restated equity incentive plan		200,000	100,000

INCOME TAXES (Details Narrative

INCOME TAXES (Details Narrative) - USD ($)	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020	Dec. 31, 2020
Operating Loss Carryforwards [Line Items]
Income Tax Expense (Benefit)	$ 232,000	$ (62,000)	$ 20,000	$ (18,000)
Current Income Tax Expense (Benefit)	245,000		160,000
Deferred Income Tax Expense (Benefit)	13,000		$ 140,000
Threshold deductible interest expenses description			the ability to carry back net operating losses incurred from tax years 2018 through 2020 up to the five preceding tax years.
Deferred payroll taxes current					$ 927,000
Cares Act [Member]
Operating Loss Carryforwards [Line Items]
Deferred payroll taxes current	1,900,000		$ 1,900,000		$ 1,900,000
Cares Act [Member] | Maximum [Member]
Operating Loss Carryforwards [Line Items]
Threshold deductible interest expenses period			39 years
Cares Act [Member] | Minimum [Member]
Operating Loss Carryforwards [Line Items]
Threshold deductible interest expenses period			15 years
Internal Revenue Service (IRS) [Member]
Operating Loss Carryforwards [Line Items]
Operating loss carryback claim amount	$ 285,000		$ 285,000

SCHEDULE OF FAIR VALUE, LIABILI

SCHEDULE OF FAIR VALUE, LIABILITIES MEASURED ON RECURRING BASIS, UNOBSERVABLE INPUT RECONCILIATION (Details) - Fair Value, Inputs, Level 3 [Member] - USD ($) $ in Thousands	9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Balance, beginning
Acquisition	6,500	1,000
Change in fair value		(500)
Payments
Balance, ending	$ 6,500	$ 500

SCHEDULE OF REVENUES, OPERATING

SCHEDULE OF REVENUES, OPERATING EXPENSES AND OPERATING INCOME (LOSS) BY REPORTABLE SEGMENT (Details) - USD ($) $ in Thousands	3 Months Ended		9 Months Ended
	Sep. 30, 2021	Sep. 30, 2020	Sep. 30, 2021	Sep. 30, 2020
Segment Reporting Information [Line Items]
Net revenue	$ 38,304	$ 31,639	$ 102,137	$ 73,085
Net revenue	24,124	19,718	62,719	45,842
Net revenue	2,375	1,571	6,469	4,778
Net revenue	5,921	6,191	17,814	17,176
Net revenue	488	2,367	4,328	6,846
Net revenue		(500)		(500)
Net revenue	3,547	3,206	9,505	6,944
Net revenue	424	321	1,664	681
Net revenue	36,879	32,874	102,499	81,767
Net revenue	1,425	(1,235)	(362)	(8,682)
Healthcare IT [Member]
Segment Reporting Information [Line Items]
Net revenue	34,678	28,191	92,797	64,159
Net revenue	21,324	17,147	55,473	39,074
Net revenue	2,368	1,563	6,446	4,753
Net revenue	3,336	4,173	10,175	11,067
Net revenue	488	2,367	4,328	6,846
Net revenue		(500)		(500)
Net revenue	3,459	3,127	9,251	6,706
Net revenue	424	321	1,664	681
Net revenue	31,399	28,198	87,337	68,627
Net revenue	3,279	(7)	5,460	(4,468)
Medical Practice Management [Member]
Segment Reporting Information [Line Items]
Net revenue	3,626	3,448	9,340	8,926
Net revenue	2,800	2,571	7,246	6,768
Net revenue	7	8	23	25
Net revenue	471	468	1,487	1,493
Net revenue
Net revenue
Net revenue	88	79	254	238
Net revenue
Net revenue	3,366	3,126	9,010	8,524
Net revenue	260	322	330	402
Unallocated Corporate Expenses [Member]
Segment Reporting Information [Line Items]
Net revenue
Net revenue
Net revenue
Net revenue	2,114	1,550	6,152	4,616
Net revenue
Net revenue
Net revenue
Net revenue
Net revenue	2,114	1,550	6,152	4,616
Net revenue	$ (2,114)	$ (1,550)	$ (6,152)	$ (4,616)

SEGMENT REPORTING (Details Narr

SEGMENT REPORTING (Details Narrative)	9 Months Ended
	Sep. 30, 2021Segment
Segment Reporting [Abstract]
Number of operating segment	2