The Revenue Integrity Show

ED facility levels and critical care (October 21, 2021)

Play Episode Listen Later Oct 21, 2021 31:27

ED facility levels and critical care Caroline Znaniec, Managing Director, CohnReznick LLP's Healthcare Advisory Practice, Baltimore, Maryland Marie Garcia, System Manager Revenue Integrity – Charge Christian S. Gabriel, National Director of Revenue Integrity at CommonSpirit Health, Glendale, California

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Healthcare Consumer Payment Trends(October 7, 2021)

Play Episode Listen Later Oct 8, 2021 33:06

Healthcare Consumer Payment Trends Sue Egan, CPC, CRC, CEDC, CPMA, Associate Director, Financial Solutions, Guidehouse, Charlotte, North Carolina Holly Steinman, RHIT, COC, CPC, CRC, COBGC, COSC, Managing Consultant, Financial Solutions, Guidehouse, Grand Rapids, Michigan Kristine Roloson, CPC, Managing Consultant, Financial Solutions, Guidehouse, New York Graham Block, CHFP, CSMC, CRCR, Senior Consultant, Financial Solutions, Guidehouse, New York Paul Mannix, Senior Consultant, Financial Solutions, Guidehouse, Chicago

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Healthcare Consumer Payment Trends (September 23, 2021)

Play Episode Listen Later Sep 24, 2021 20:19

Topic: Healthcare Consumer Payment Trends Featuring • David Stievater, Senior Partner, CWH Advisors • Henri Cattier, Senior Partner, CWH Advisors • Laurie Heavey, Sr. Vice President, Marketing, ClearBalance HealthCare

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The State of Price Transparency (September 9, 2021)

Play Episode Listen Later Sep 8, 2021 23:27

Topic: The State of Price Transparency Featuring: David Mistkawi, MBA, vice president, access management solutions, The SSI Group

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Clinical documentation data holds the key to relieving physician burnout (August 26, 2021)

Play Episode Listen Later Aug 27, 2021 21:52

Topic: Clinical documentation data holds the key to relieving physician burnout Featuring: Mary Pat Langer, Director, HIM Services, DeliverHealth

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Data-Driven Denial Prevention: New Tactics to Halt Old Finger Pointing (July 29, 2021)

Play Episode Listen Later Jul 30, 2021 27:03

Title: Data-Driven Denial Prevention: New Tactics to Halt Old Finger Pointing Featuring: Shannon Case, Managing Consultant, Baker Tilly Geneva Schlabach, Co-Founder and CEO, VISPA

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Life After the Pandemic: What Are Employees Looking For? (July 15, 2021)

Play Episode Listen Later Jul 20, 2021 33:42

Title: Life After the Pandemic: What Are Employees Looking For? Presented by: Stacey McCreery, MBA, and Julie Teixeira, both of ROI Search Group

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Defining a Revenue Integrity Department Structure

Play Episode Listen Later Jun 3, 2021 29:49

Defining a Revenue Integrity Department Structure Featuring: Melissa Deuel, System Manager, Charge Master, CommonSpirit Health Christian S. Gabriel, National Director of Revenue Integrity, CommonSpirit Health Marie Garcia, System Manager, Revenue Integrity, CommonSpirit Health

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2022 IPPS Proposed Rule (May 20, 2021)

Play Episode Listen Later May 20, 2021 28:22

Topic: 2022 IPPS proposed rule Featuring: Jugna Shah, MPH, CHRI, President, Nimitt Consulting Inc.

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Turning Denials into Change Agents (May 6, 2021)

Play Episode Listen Later May 6, 2021 24:47

Topic: Turning Denials into Change Agents Featuring: Lisa Knowles, RHIT, CCS, CHC, senior director, client solutions, Harmony Healthcare, Tampa, Florida

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Keeping Your Clinical Documentation Safe: A Business Continuity Checklist for 2021

Play Episode Listen Later Apr 22, 2021 25:37

Topic: Keeping Your Clinical Documentation Safe: A Business Continuity Checklist for 2021 Featuring: Michael Clark, CEO, DeliverHealth

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Tackling COVID-19 Vaccination Billing Challenges: A System Approach (April 8, 2021)

Play Episode Listen Later Apr 8, 2021 22:29

Topic: Tackling COVID-19 Vaccination Billing Challenges: A System Approach Featuring: Melissa Deuel, System Manager, Charge Master, CommonSpirit Health Christian S. Gabriel, National Director of Revenue Integrity, CommonSpirit Health Marie Garcia, System Manager, Revenue Integrity, CommonSpirit Health Kay Larsen, CRCR, CHRI, Revenue Integrity Specialist, Adventist Health Glendale

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Wind Down Legacy A/R and Set Your Organization Up for Success (March 25, 2021)

Play Episode Listen Later Mar 29, 2021 20:16

Topic: Wind Down Legacy A/R and Set Your Organization Up for Success Featuring: Jeremy Henry, VP of Business Development, Harmony HealthIT

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Hindsight is Always 20/20: Revenue Integrity Tips I Wish I Knew Last Year (March 11, 2021)

Play Episode Listen Later Mar 11, 2021 26:10

Topic: Hindsight is Always 20/20: Revenue Integrity Tips I Wish I Knew Last Year Featuring: Kay Larsen, CRCR, CHRI, Revenue Integrity Specialist, Adventist Health Glendale Sarah L Goodman, MBA, CHCAF, COC, CCP, FCS, President/CEO, SLG, Inc.

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Updates on the Inpatient-Only List and Price Transparency (February 25, 2021)

Play Episode Listen Later Feb 25, 2021 29:26

Topic: Updates on the Inpatient-Only List and Price Transparency Featuring: Ronald Hirsch, MD, FACP, CHCQM, Vice President, R1 Physician Advisory Services Caroline Znaniec, Managing Director, CohnReznick LLP's Healthcare Advisory Practice, Baltimore, Maryland

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Four Strategies to Better Manage Your Self-Pay Accounts (February 11, 2021)

Play Episode Listen Later Feb 11, 2021 23:42

Topic: Four Strategies to Better Manage Your Self-Pay Accounts Featuring: Juli Forde, Director of Strategic Partnerships, AR Optimization, ZOLL Data Systems

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CMS Price Transparency: Where Will We Go From Here? (January 28, 2021)

Play Episode Listen Later Jan 28, 2021 31:35

Topic: CMS Price Transparency: Where Will We Go From Here? Guests: John D. Settlemyer, MBA, MHA, CPC, CHRI, Associate VP Revenue Cycle, Atrium Health Angela Lynne Simmons, CPA, VP Revenue and Reimbursement, Vanderbilt University Medical Center Grace Upleger, MBA, PMP, CPHIMS, Director, Patient Financial Services, Vanderbilt University Medical Center in Nashville

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Evolving as a Hospital Revenue Cycle Claims Analyst in 2021 (January 14, 2021)

Play Episode Listen Later Jan 14, 2021 31:56

Topic Evolving as a Hospital Revenue Cycle Claims Analyst in 2021 Featuring Karla R. Gibbs, BA, COC-H Revenue integrity analyst UCLA Health System, Los Angeles

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Quantifying the Importance of Ambulatory Order Visibility (December 17, 2020)

Play Episode Listen Later Dec 17, 2020 24:22

Topic: Quantifying the Importance of Ambulatory Order Visibility Featuring: Denny Phillips, President, iPro Healthcare Ronnie Sutton, Director of Software Services, iPro Healthcare

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Patient Experience, Affordable Care, and Financial Performance (December 3, 2020)

Play Episode Listen Later Dec 2, 2020 27:41

Topic: A Continual Balancing Act: Patient Experience, Affordable Care, and Financial Performance Featuring: Buffy Higgins, Sr. Director, Revenue Cycle, MaineGeneral Health Laurie Heavey, VP Marketing, ClearBalance HealthCare Stacey Russell, Accounts Receivable Supervisor, MaineGeneral Health

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Complying with CMS Pricing Transparency: Last Minute Advice (November 19, 2020)

Play Episode Listen Later Nov 19, 2020 29:36

Discussion: • Recapping the two major provisions • Options for creating comprehensive machine-readable files • Overview of Corrective Action Plan/Civil Monetary Penalties • Planning for your customer service/media response • Unrelated: Publish your COVID testing pricing • Advocacy

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Rating a Denial for the Possibility of Overturn (November 5, 2020)

Play Episode Listen Later Nov 5, 2020 27:05

Topic: Rating a Denial for the Possibility of Overturn Agenda: Introduce the concept of an appeal scoring tool Discuss the power of the tool Considerations in developing an appeal scoring tool Featuring: Denise Wilson, MS, RN, RRT, senior vice president of Denial Research Group – AppealMasters Tracey A. Tomak, RHIA, PMP, director of project management and client engagement at Intersect Healthcare in Towson, Maryland

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The Need for Intelligent Process Automation in the Revenue Cycle (October 22, 2020)

Play Episode Listen Later Oct 22, 2020 26:03

Topic: The Need for Intelligent Process Automation in the Revenue Cycle Featuring: Pavani Munjulri, Co-Founder and COO, Cognitive Health IT

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Upcoming 2021 E/M Professional Fee Changes (September 24, 2020)

Play Episode Listen Later Sep 24, 2020 22:54

Agenda: Review the upcoming 2021 evaluation and management (E/M) professional fee changes Challenges/opportunities that providers will need to consider How will compliance and revenue integrity need to handle these changes Featuring: Dr. Ven Mothkur, MD, MSc, co-found and principal of Revenire Health Dr. Neil Ramani, MD, CCDS, healthcare entrepreneur

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The Revenue Cycle's Necessary Oddity (September 10, 2020)

Play Episode Listen Later Sep 10, 2020 27:28

The Revenue Cycle's Necessary Oddity Featuring: Stephanie Ellis, RN, BSN, COC, director, revenue performance and audit management, University of Chicago Medical Center Yesenia Servin, CPMSM, PESC, payer enrollment lead, Loyola University Health System Agenda: The revenue cycle from the perspective of an enrollment specialist The impact of credentialing and enrollment on the revenue cycle The key collaborators

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2021 OPPS and MPFS proposed rules(August 27)

Play Episode Listen Later Aug 27, 2020 35:54

2021 OPPS and MPFS proposed rules - August 27 Featuring: Debra May, Executive Partner, Bluetree Network Jugna Shah, MPH, CHRI, President, Nimitt Consulting Inc. Denise Williams, COC, CHRI, Senior VP, Revenue Integrity Services, REVANT Solutions

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2021 OPPS Proposed Rule (August 13)

Play Episode Listen Later Aug 13, 2020 24:36

2021 OPPS Proposed Rule - August 13 Featuring: Ronald Hirsch, MD, FACP, CHCQM, Vice President, R1 Physician Advisory Services

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Telehealth Services: Some Smooth Sailing, but Still Choppy Waters (July 30)

Play Episode Listen Later Jul 30, 2020 28:48

Telehealth Services: Some Smooth Sailing, but Still Choppy Waters - July 30 Featuring: Jennie Bryan, MBA, RHIA, CCS, healthcare risk client-based associate manager for Crowe Healthcare Risk Consulting LLC, in Clayton, Missouri Denise Williams, COC, senior vice president, revenue integrity services, REVANT Solutions, Trussville, Alabama

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Data and Key Performance Indicators: Point, Counterpoint (July 16)

Play Episode Listen Later Jul 16, 2020 32:13

Topic: Featuring: Ronald Hirsch, MD, FACP, CHCQM, Vice President, R1 Physician Advisory Services Caroline Znaniec, Managing Director, CohnReznick LLP's Healthcare Advisory Practice, Baltimore, Maryland

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Hospital Strategic Pricing - July 2

Play Episode Listen Later Jul 6, 2020 29:23

Hospital Strategic Pricing: Opportunities in Our Healthcare Pricing Business Model Agenda: With new transparency laws going into effect and hospital pricing increases still being the major driver of hospital revenue, the discussion will be in regards to opportunities in our current model and then discuss how hospitals can still react despite today's current environment of price wars. Featuring: Christian Gabriel, MBA, BSN, RN, CPC, CCS, System Revenue Integrity Director, CommonSpirit Health Matt Linderman, MBA, System Vice Presdient of Revenue Assurance, CommonSpirit Health Maulik Shah, MSF, Pricing and Revenue Integrity Strategist, University of Utah Health

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Clean-up on Aisle [COVID] 19 - June 18

Play Episode Listen Later Jun 18, 2020 26:33

Featuring: Sarah L Goodman, MBA, CHCAF, COC, CCP, FCS, President/CEO, SLG, Inc. Kay Larsen, CRCR, CHRI, Revenue Integrity Specialist, Adventist Health Glendale Agenda: This episode of the Revenue Integrity Show will address the aftermath and follow-up of the numerous COVID-19 changes impacting revenue integrity in the facility setting over the past few months.

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Managing Clinical Research Finance During a Pandemic - June 4

Play Episode Listen Later Jun 4, 2020 29:17

June 4 - Managing Clinical Research Finance During a Pandemic: A Focus on Revenue Cycle Impacts Featuring: Mary Veazie, MBA, CPA, CHC, CHRC, executive director of clinical research finance at the University of Texas MD Anderson Cancer Center in Houston Victoria M. Johnson, MBA, CPC, an analytical healthcare leader with more than 15 years of revenue cycle experience Agenda: During normal operations, managing the financial aspects of clinical research is a challenging and complex process with a high risk-value to organizations engaged in clinical research activities. These processes are stressed and tested during a pandemic. This episode of The Revenue Integrity Show will provide viewers with practical techniques and processes designed to maintain compliance and mitigate risk during a crisis like COVID-19.

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Advocacy Opportunities Now: COVID-19 and the IPPS Proposed Rule (May 21)

Play Episode Listen Later May 21, 2020 32:27

May 21 - Featuring NAHRI Professional Advocacy Committee and Advisory Board Members: Terri Rinker, MT (ASCP), MHA, CHRI, Revenue Cycle Director, Community Hospital Anderson John D. Settlemyer, MBA, MHA, CPC, CHRI, Associate VP Revenue Cycle, Atrium Health Jugna Shah, MPH, CHRI, President, Nimitt Consulting Inc. Denise Williams, COC, CHRI, Senior VP, Revenue Integrity Services, REVANT Solutions Agenda: Members of the NAHRI Professional Advocacy Committee and NAHRI Advisory Board discuss the top points related to COVID-19 rules and the 2021 IPPS proposed rule and offer guidance on submitting comments to CMS. Several rules are open for comment right now and there is no better time than the present to get tips for commenting.

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The Revenue Integrity Show: A NAHRI Podcast (May 7, 2020)

Play Episode Listen Later May 7, 2020 31:22

May 7 - COVID-19 for Revenue Integrity: The Perspective of a Physician and an Operations Expert Featuring NAHRI Advisory Board Members: Ronald Hirsch, MD, FACP, CHCQM, CHRI, Vice President, R1 Physician Advisory Services Lisa Kanivetsky, BA, CPC, CHRI, Operations Director, Navigant Agenda: Implications of HRSA programs on uninsured and indigent patients with COVID-19 Application of Modifier -CS Use of laboratory and specimen collection codes for COVID-19 Explanation of clinical aspects of COVID-19 and coding with U07.1 Discussion of insurance coverage and claims submission for COVID-19

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The Revenue Integrity Show: A NAHRI Podcast (April 23, 2020)

Play Episode Listen Later Apr 24, 2020 38:17

The Revenue Integrity Show is a bi-weekly podcast presented by the National Association of Healthcare Revenue Integrity (NAHRI). Streaming live every other Thursday at 3 p.m., a recording of The Revenue Integrity Show is later available via iTunes, Google Play, and Spotify. Register for free to join us for the live portion of our show. Opt you into all future episodes of The Revenue Integrity Show so you won't forget to join us for the latest revenue integrity news and guidance. For questions or to become a guest on The Revenue Integrity Show, email nahri@hcpro.com or visit www.nahri.org/podcast. Additional information is forthcoming. April 23 - COVID-19 Billing Implications: The Current Telehealth Landscape Agenda: Billing for hospital outpatient telehealth, hospital-based teletherapies (e.g., physical therapy, occupational therapy), and telehealth for diabetes self-management Potential long-term implications of COVID-19 on telehealth Featuring: Jugna Shah, MPH, CHRI, President, Nimitt Consulting Inc. (moderator) Valerie Rinkle, MPA, CHRI, Regulatory Specialist, HCPro (guest) John D. Settlemyer, MBA, MHA, CPC, Associate VP Revenue Cycle, Carolinas HealthCare System (guest) Angela Lynne Simmons, CPA, VP Revenue and Reimbursement, Vanderbilt University Medical Center (guest) Jaclyn Fitzgerald, CHRI, Director of NAHRI (host