Podcasts about revenue cycle

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Best podcasts about revenue cycle

Latest podcast episodes about revenue cycle

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: The Hidden Hazards of Surgical Prior Auth

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Jul 9, 2025 26:24


The Hidden Hazards of Surgical Prior Auth Prior authorization for surgical procedures continues to be one of the most frustrating and costly hurdles in the revenue cycle. In this episode, Bo Bowman and Stuart Newsome unpack the hidden hazards that routinely derail authorizations—before a procedure is even scheduled. Drawing on firsthand experience and fresh examples from real-world surgical workflows, they explore the most common pitfalls, including failure to prove medical necessity, inaccurate procedural coding, insufficient documentation, and timing missteps. They also touch on the role automation and AI can play in supporting human teams—helping to surface missing requirements, flag coding mismatches, and push authorizations forward before deadlines hit. Whether you're on the clinical side, in operations, or supporting from RCM or technology, this session will give you a clearer path forward and arm you with the awareness needed to avoid denials, delays, and administrative fatigue.

Revenue Cycle Optimized
RCM Insights - The Hidden Hazards of Missed Charges

Revenue Cycle Optimized

Play Episode Listen Later Jul 7, 2025 29:37


Willie Brown, MBA, MT(ASCP), CRCA, VP of Revenue Cycle at Sentara Health, and Taylor Searfoss, RCM Expert at Infinx's Ni2 Hospital Division, share real-world strategies to fix charge capture blind spots that quietly drain revenue. This conversation reveals how aligning clinical, IT, and rev cycle teams around root causes—not band-aids—can build lasting financial and operational resilience.

Monitor Mondays
Breaking News: A Major Regulatory Shift

Monitor Mondays

Play Episode Listen Later Jul 7, 2025 28:52


The Transparency in Coverage (TiC) Final Rule represents one of the most significant regulatory shifts in healthcare pricing since the implementation of the Patient Protection and Affordable Care Act.During the next live edition of Monitor Mondays, senior healthcare analyst Frank Cohen will walk you and your team through the comprehensive labyrinth of changes.Recent enforcement developments, including President Trump's Executive Order 14221, directing actual hospital price disclosure within 90 days, also signal an intensified regulatory environment requiring proactive compliance strategies.The venerable broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Moesha Baptiste, intern regulatory analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

Monitor Mondays
Chevron Deference: What Difference Has a Year Made?

Monitor Mondays

Play Episode Listen Later Jul 7, 2025 29:35


Looking back and looking ahead, we must reckon with a major shift in America's judicial landscape: the elimination of the so-called Chevron Deference. Last year, at about this same time, physician and attorney Dr. John K. Hall was the special guest here on Monitor Mondays, and he began his segment explaining the legal concept.Now, more than a year after the U.S. Supreme Court's landmark decision overturning 40 years of judicial precedent and upending statutory construction and enforcement, we must ask, has anything really changed?Dr. Hall will return to examine the changes – or maybe lack of changes – and what we might still expect regarding legal challenges to executive actions.The venerable broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Adam Brenman, senior regulatory affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

Revenue Cycle Optimized
Bridging Gaps with Data Across the Revenue Cycle

Revenue Cycle Optimized

Play Episode Listen Later Jul 1, 2025 13:34


Stuart Newsome shares a multi-perspective approach to revenue cycle analytics, showing how smart data bridges gaps between operations, clients, and strategy.Brought to you by www.infinx.com

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: Six Shifts Shaping RCM Influenced by AI Agents

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Jun 25, 2025 30:23


Six Shifts Shaping RCM Influenced by AI Agents In 2025, revenue cycle management is being reshaped by the rapid advancement of automation and the emergence of intelligent AI agents. This session explores six major shifts that are redefining how healthcare providers manage claims, denials, eligibility, and financial performance — all through the lens of AI-enabled transformation. Built from real conversations with revenue cycle leaders, clinical teams, and healthcare finance professionals, this session offers a strategic breakdown of where RCM is headed and what's holding organizations back. From the transition to platform-first strategies, to the increasing need for secure and resilient infrastructure, to the rethinking of workforce models around digital assistance — we'll dive into the practical realities shaping today's automation landscape. With AI agents now acting as collaborators, not just tools, healthcare organizations are beginning to realize new efficiencies, enhanced compliance, and measurable ROI. This session goes beyond hype and gets into how automation is truly impacting day-to-day revenue operations. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Monitor Mondays
Fraud, Waste, and Abuse: The 2025 Triple Crown

Monitor Mondays

Play Episode Listen Later Jun 23, 2025 31:52


Call it a trifecta, triumvirate, or the Triple Crown of 2025.“Fraud, waste, and abuse” is the current triple-negative buzzword in America's lexicon. And it's being used to describe lots of things. But when that phrase is used by the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG), what does it actually mean?You'll learn during the next live edition of Monitor Mondays.That's when senior healthcare consultant Dr. Drew Updike – the broadcast's special guest – will report on how the Acting HHS Inspector General (IG) Juliet Hodgkins used that phrase when she recently posted an online promotion in support of the OIG Spring Semiannual report to Congress.The venerable broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Matthew Albright, chief legislative government affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

Becker’s Healthcare Podcast
Blake Evans, System Vice President of Revenue Cycle at Rush University System for Health

Becker’s Healthcare Podcast

Play Episode Listen Later Jun 19, 2025 15:52


This episode features Blake Evans, System Vice President of Revenue Cycle at Rush University System for Health, sharing his journey from frontline registration to executive leadership. He discusses his first 90 days in the role, building a unified vision, embracing automation, and navigating major revenue cycle challenges and opportunities with a focus on team alignment and transparent communication.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: Staying Ahead in the AI Arms Race with Payors

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Jun 18, 2025 29:46


Staying Ahead In The AI Arms Race With Payors As artificial intelligence takes a front seat in revenue cycle operations, providers are confronting a fast-changing landscape shaped by payor-driven automation. Denials are being issued in seconds. Post-payment reviews are ramping up. And compliance, once a back-office function, is now a strategic necessity. In this special Office Hours session, Stuart Newsome distills the most important insights from his AAPC HEALTHCON presentation and a prior HFMA segment—delivering a clear-eyed look at the AI arms race between payors and providers. The session will examine how payors are deploying AI to control costs, how providers can avoid costly compliance missteps, and what governance structures are needed to keep automation accountable. Attendees will leave with a practical understanding of the risks and remedies surrounding AI in healthcare RCM, plus actionable steps to build resilient compliance programs that evolve with the technology. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Pharmacy Innovators Podcast
Maximizing Value in the Pharmacy Revenue Cycle

Pharmacy Innovators Podcast

Play Episode Listen Later Jun 18, 2025 43:44


In this episode of The Innovators Podcast, host Jim Jorgenson is joined by pharmacy revenue cycle experts Maxie Friemel and Tim Miller to explore the often underestimated, and increasingly critical, world of pharmacy finances. The conversation goes well beyond billing, diving into key issues such as prior authorizations, denials, biosimilar adoption, charge structures, and payer audits. For hospital and health system leaders, the pharmacy revenue cycle presents both significant risk and opportunity. As specialty drug costs rise and payer scrutiny intensifies, understanding pharmacy's role in financial performance is more important than ever. Maxie and Tim share practical insights to help leaders foster collaboration across pharmacy, finance, compliance, and IT, improve charge capture, and drive clean claims. Packed with actionable strategies and big-picture thinking, this is a must-listen episode for any hospital leader focused on strengthening financial sustainability and operational alignment.

healthsystemCIO.com
Redefining Revenue Cycle: Exploring Opportunities for Technology Leaders to Drive Change

healthsystemCIO.com

Play Episode Listen Later Jun 18, 2025 58:34


As health systems face mounting financial pressures, improving the revenue cycle has become a priority. This webinar brings together IT executives to explore a holistic approach to claims management — integrating technology, process optimization and payer collaboration. Panelists will discuss how AI-driven solutions have the potential to enhance claims accuracy, reduce denials and streamline workflows — while also ensuring clinicians are better supported in documentation practices. The discussion will also examine the evolving role of IT leaders in bridging gaps between clinical teams and financial operations, ultimately helping health systems get paid for the care they provide. Join us for an insightful conversation on the intersection of informatics, automation and revenue integrity in modern healthcare organizations. Source: Redefining Revenue Cycle: Exploring Opportunities for Technology Leaders to Drive Change on healthsystemcio.com - healthsystemCIO.com is the sole online-only publication dedicated to exclusively and comprehensively serving the information needs of healthcare CIOs.

Becker’s Healthcare Podcast
How University Health Is Tackling Payer Pressure and Driving Mission-Driven Revenue Cycle Innovation with Kevin Barron

Becker’s Healthcare Podcast

Play Episode Listen Later Jun 16, 2025 29:27


In this episode, Kevin Barron, Deputy VP of Payer Relations at University Health, shares how his team is navigating increasingly aggressive payer tactics, implementing smarter contract oversight, and championing a mission-first approach to revenue cycle operations. He also explains why aligning contracting within RevCycle has delivered measurable results for patient care and financial performance.

Monitor Mondays
Compliance Quicksand: Sepsis

Monitor Mondays

Play Episode Listen Later Jun 16, 2025 30:15


Clinical denials by payers for sepsis continues. The problem: the definition of the enigmatic condition does not meet their propriety definitions.Enter Dr. James Kennedy, who will be the special guest during the next live edition of the long-running Monitor Mondays broadcast. Dr. Kennedy will report on his recent conversations with the Centers for Disease Control and Prevention (CDC) National Center for Health Statistics, in which the agency described its protocols in amending the Index and Table to fit new diseases and terminology.The venerable broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Adam Brenman, senior healthcare government affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

Revenue Cycle Optimized
RCMinutes - How Provider Documentation Impacts Revenue Cycle Performance

Revenue Cycle Optimized

Play Episode Listen Later Jun 11, 2025 3:29


Incomplete or delayed provider documentation can stall coding, create charge lag, and reduce revenue cycle performance. In this episode, learn how improving clinical documentation at the point of care leads to faster claims, fewer denials, and better financial outcomes.

Monitor Mondays
Medicaid Madness

Monitor Mondays

Play Episode Listen Later Jun 9, 2025 31:13


The nation's Medicaid program has seen better days. Recently, the federal government's program to provide healthcare coverage to America's low-income and vulnerable citizens was used as a bargaining chip as congressional Republicans were in the throes of budget negotiations, facing the daunting task to pass what President Trump calls his “big, beautiful bill:” a package of tax breaks disproportionately favoring the wealthy and spending cuts. The bill, which last week passed in the U.S. House of Representatives, is now making its way through the Senate.Then there was the announcement this midweek that the Deputy Administrator and Director of the Center for Medicaid and Children's Health Insurance Program (CHIP) Services, Drew Synder, was resigning from the federal agency.Reporting on these developing stories during the next live edition of the long-running Internet broadcast Monitor Mondays will be Drew Updike, MD.The venerable broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Cate Brantley, senior healthcare government affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: Lab Revolution in the Age of AI and Access

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Jun 7, 2025 19:23


Lab Revolution In The Age Of AI And Access How do today's diagnostic laboratories grow, stay compliant, and remain profitable while facing staffing shortages, payer complexity, and soaring demand for advanced testing? On this special episode, they sit down with Ashish Dua, President and Co-Founder of Glidian, a company recently welcomed into the Infinx family. With deep expertise in laboratory workflows and prior authorization automation, Ashish shares how Glidian is helping labs—from scrappy startups to academic medical centers—scale faster, reduce overhead, and win physician loyalty by solving access barriers. The conversation explores how AI is transforming lab revenue cycle operations, not just by removing administrative burden, but by enabling entirely new workflows—such as acting as prior auth agents for physicians and training algorithms to interpret analog responses from payers. We'll also discuss how shifting the burden of prior authorization from providers to labs is creating a new dynamic where labs can move from being cost centers to true revenue drivers. Ashish brings perspective from working with labs that perform high-volume molecular diagnostics, including non-invasive prenatal testing (NIPT) and hereditary cancer screenings like BRCA1/2, offering a timely view into what it really takes to operate a modern, financially sustainable lab in 2025. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: How Chesapeake Medical Imaging Cut Processing Time from Days to Hours

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Jun 3, 2025 36:26


From Paper to Patient-Ready – How Chesapeake Medical Imaging Cut Processing Time from Days to Hours Manual faxes. Delayed scheduling. Lost visibility. These were everyday struggles for Chesapeake Medical Imaging (CMI) before 2021—until they replaced their paper-based workflows with a fully integrated, real-time solution connecting their RIS, referring providers, and a streamlined prior authorization engine. In this live panel, we'll hear how CMI's operations team tackled inefficiencies head-on, partnered with ScriptSender and Infinx, and built a technology-driven process that now supports 40% electronic order intake, same-day patient contact, and 20% growth in volume—without additional staffing. CMI leadership will share lessons learned, pitfalls avoided, and what they'd do differently if they had to do it again. Whether you're still fax-based or knee-deep in modernization, this conversation will offer real-world strategies for reclaiming your team's time, improving patient access, and boosting referral satisfaction. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Monitor Mondays
Whistleblower Update: Rheumatologist Sentenced to Jail, Must Forfeit Maserati and Other Possessions

Monitor Mondays

Play Episode Listen Later Jun 2, 2025 29:27


During the next edition of Monitor Mondays, famed whistleblower attorney Mary Inman, partner at Whistleblower Law, will provide an update on a whistleblower case that some consider “beyond bad.”You'll learn why a Texas rheumatologist who was sentenced to 10 years in prison and three years of supervised release was ordered to forfeit more than $28 million, plus 13 real-estate properties, a jet, and a Maserati GranTurismo sports car.Inman, long considered one of the nation's foremost whistleblower attorneys, will be the program's special guest during the next live edition of the venerable Internet broadcast, coming up at 10 a.m. EST on Monday, June 2, 2025.The long-running broadcast will also include these instantly recognizable features:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.Field Report: Drew Updike will continue his reporting on efforts by the Trump Administration to intervene in healthcare issues – namely the Centers for Medicare & Medicaid Services (CMS) Form 64 related to migrants and Medicaid.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: What's Next for Orthopedics? Lessons from the AAOE 2025 Conference

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later May 28, 2025 20:48


What's Next For Orthopedics? Lessons From The AAOE 2025 Conference Hear fresh insights from the AAOE 2025 Conference as David Byrd, Lora Pada, and Danelle Newman break down the top trends shaping orthopedic practices today. Learn what's working, what's changing, and how ortho leaders like OSS Health are turning conference takeaways into real-world results. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

The Hospital Finance Podcast
Understanding Denials-Strategies for Improvement in the Revenue Cycle Webinar

The Hospital Finance Podcast

Play Episode Listen Later May 28, 2025 7:12


In this episode, Olga Barone-Allan provides a glimpse into BESLER's free webinar, Understanding Denials: Strategies for Improvement in the Revenue Cycle, presented live on June 4, 1 PM ET.

Nobody Told Me That! with Teresa Duncan
EP 150 She Turned $40/mo Side Hustle into a 7-Figure Dental Business!

Nobody Told Me That! with Teresa Duncan

Play Episode Listen Later May 24, 2025 63:19


More management and insurance knowledge in my newsletter: https://www.odysseymgmt.com/newsletter   She started charging just $40 a month—now she runs a business that hit 7 figures. In this episode, Amanda DeMoura shares how her small side hustle evolved into a thriving dental business, what it really took behind the scenes, and the unexpected turns that shaped her success. In this episode, we talk about her journey from the ground up, navigating remote work and entrepreneurship, and what happens when growth forces you to make big, uncomfortable decisions. If you're in the dental industry, healthcare admin, or just curious how real businesses are built behind the scenes, this conversation is full of honest moments. It's a story about ownership, reinvention, and figuring it out as you go. Connect with Amanda: Website: https://amandademoura.com/ Email: Amanda@amandademoura.com Podcast: Breath of Fresh Air - Dental Podcast ------------- I created Dental Revenue Network to foster collaboration and networking amongst RCM professionals. Billing company owners and billing professionals will have access to skill building sessions, current carrier news and insurance discussions beyond “what's the code?" Check it out - I hope you'll join! https://dentalrevenuenetwork.mn.co/ ------------- Medical Billing Made Easy! Dental Classroom Online: https://www.dentalclassroomonline.com/ Use ODYSSEY for a 10% courtesy ------------- *Is your AR out of control? Is your admin team burning out?

Becker’s Healthcare Podcast
The Value of Physician Expertise in the Revenue Cycle: Insights from Emory Healthcare and Accuity

Becker’s Healthcare Podcast

Play Episode Listen Later May 20, 2025 16:37


In this episode of the Becker's Healthcare Podcast, Erika Spicer Mason speaks with Dr. Jessica Nave of Emory Healthcare and Dr. Sari Green of Accuity about the transformative impact of physician involvement in revenue cycle management. They explore how clinical expertise is helping health systems address denials, improve documentation accuracy, and navigate tightening financial margins through strategic partnerships and innovation. Tune in to learn how Emory and Accuity are advancing a more integrated, physician-led approach to RCM success.This episode is sponsored by Accuity.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: Protecting Revenue With Safety Nets For Timely Filing

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later May 20, 2025 26:08


Protecting Revenue With Safety Nets For Timely Filing Epic go-lives and other EHR transitions can be chaotic, high-stakes operations that push revenue cycle teams to the limit. When claim work queues go unattended—even for a few weeks—organizations can lose millions in timely filing denials. On this episode Stuart Newsome, VP of Marketing at Infinx, welcomes Tadd Miller, AR Manager at Ni2, an Infinx company, to share how his team averted disaster during a major Epic implementation by developing practical, real-world safety nets. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Monitor Mondays
Tariffs: The Impact on Drugs

Monitor Mondays

Play Episode Listen Later May 19, 2025 30:00


Welcome to a strange new world.Recent tariffs announced by the Trump Administration are likely to impact drug manufacturing, since many drug components are produced outside the U.S., in nations such as in India, giving rise to state laws. Many states limit overseas involvement relative to the Health Insurance Portability and Accountability Act (HIPAA). Florida, for example, prohibits the offshoring of certain patient data, requiring such storage to be within the U.S.Responding to this emerging crisis, the producers of RACmonitor and Monitor Mondays have invited Lexi Morrison, director of operations at MedPharma, to be the program's special guest during the next live edition of the venerable Internet broadcast, coming up at 10 a.m. EST on Monday, May 19.The long-running broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Adam Brenman, senior government affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

Becker’s Healthcare Podcast
Driving Denial Prevention and Data-Driven Innovation in Revenue Cycle with Dennis Shirley of UnityPoint Health

Becker’s Healthcare Podcast

Play Episode Listen Later May 16, 2025 12:18


In this episode, Dennis Shirley, Vice President of Revenue Cycle at UnityPoint Health, discusses how his team earned national recognition for excellence in denial management. He shares how data, clinical collaboration, and cautious adoption of automation and AI are helping to transform their revenue cycle operations while enhancing the patient financial experience.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: The Human Edge in an Automated Revenue Cycle

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later May 14, 2025 33:52


The Human Edge In An Automated Revenue Cycle Automation has reshaped the revenue cycle—but it hasn't replaced the need for expertise. In this episode of Office Hours, we welcome Evan Martin, VP of Revenue Cycle Management at ZoomCare and host of the Wilshire IT RevCast, to discuss how organizations can strike the right balance between technology and human insight. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Monitor Mondays
Speak No Evil: Asking Docs to Weigh In Became a $202 Million False Claims Act Settlement

Monitor Mondays

Play Episode Listen Later May 12, 2025 33:18


On the surface, it was the perfect scam: kickbacks to docs in exchange for public speaking engagements, in order to induce them to prescribe drugs.That's apparently what Gilead Sciences thought.But a whistleblower blew the whistle, and Gilead admitted to paying hundreds of thousands of dollars to high prescribers of their HIV drugs to serve as speakers at programs at luxury restaurants.Famed whistleblower attorney Mary Inman, partner at Whistleblowers Partners, LLP, will report the savory details during the new live edition of Monitor Mondays, coming up at 10 a.m. EST on Monday, May 12.The long-running broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Folan Houston, assistant general counsel for Zelis, will report on the news at the intersection of healthcare and congressional action.• Field Report: Dr. Drew Updike continues his reporting on recent efforts by the Trump Administration to prevent providers from undertaking gender-affirming treatments for America's LGBTQ+ population.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

S2E5: Host Don Hardwick discusses the complexities of release of information with Fabian Stone, the Vice President, Revenue Cycle Operations at Children's Hospital of Philadelphia (CHOP). Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: AAPC HEALTHCON Recap On Compliance, Change, And What's Next In RCM

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later May 6, 2025 21:24


AAPC HEALTHCON Recap On Compliance, Change, And What's Next In RCM Join Stuart Newsome, VP of Marketing at Infinx, for a candid reflection on key takeaways from the 2025 AAPC HEALTHCON conference in Orlando, Florida. This year's event offered a rich mix of content spanning compliance, legal risk, medical coding evolution, and the growing influence of technology in revenue cycle management. In this Office Hours session, Stuart will share general insights and memorable moments from sessions that explored regulatory expectations, personal liability concerns, and the industry's shifting posture toward AI and automation. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Talk Ten Tuesdays
Jumpstart Your Revenue Cycle: Get Your Motor Running

Talk Ten Tuesdays

Play Episode Listen Later May 6, 2025 27:24


The revenue cycle can be thought of as a machine that keeps churning nonstop, making everything work, financially speaking, for your hospital.But even the most well-oiled machinery can get clogged, meaning it doesn't perform at its peak. And that is why the producers of ICD10monitor and Talk Ten Tuesdays have invited Jessica Miller-Dobbs to join the popular Internet broadcast as its special guest for some shop talk.Jessica is the Director of Health Information Management (HIM) and Revenue Cycle for Datavant. She is scheduled to appear during the next live edition of Talk Ten Tuesdays, 10 a.m. Eastern on May 6, for a refreshingly new approach in learning how to get your revenue cycle humming.Also part of the live broadcast will be these instantly recognizable panelists, who will report more news during their segments:• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news that is happening at the intersection of medical record auditing and the SDoH.• The Coding Report: Christine Geiger, Assistant Vice President of Acute and Post-Acute Coding Services for First Class Solutions, will report on the latest coding news.• News Desk: Timothy Powell, ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.• MyTalk: Angela Comfort, veteran healthcare subject-matter expert, will co-host the long-running and popular weekly Internet broadcast. Comfort is the assistant vice president of revenue integrity for Montefiore Health.

Becker’s Healthcare Podcast
Bringing Retail Agility to Healthcare Revenue Cycle: Catherine LoPresti's Vision at Hackensack Meridian

Becker’s Healthcare Podcast

Play Episode Listen Later May 5, 2025 11:39


In this episode, Catherine LoPresti, VP of Professional Revenue Cycle Operations at Hackensack Meridian Health, shares how her time at Walmart Connect reshaped her approach to healthcare operations, from leveraging real-time data to empowering physicians and driving patient-centered innovation.

Monitor Mondays
340B In the Crosshairs

Monitor Mondays

Play Episode Listen Later May 5, 2025 28:01


Once again, the venerable 340B Drug Pricing Program finds itself in the crosshairs of critics – this time, from the U.S. Congress.Recently, Sen. Bill Cassidy (R-La.), ranking member of the Senate Health, Education, Labor, and Pensions (HELP) Committee, released a report outlining his office's investigation into the program.During the next live edition of Monitor Mondays, 340B Health CEO Maureen Testoni will return to the broadcast to offer her response to the senator's investigation.The long-running broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Cate Brantley, senior healthcare government affairs analyst for Zelis, will report on the news at the intersection of healthcare and congressional action.

HealthLeaders Podcast
Using Analytics to Improve Revenue Cycle Efficiency

HealthLeaders Podcast

Play Episode Listen Later May 5, 2025 14:36


TruBridge Analytics Senior Vice President Vanessa Ryan shares how oversights in data analytics cause health systems to miss out in the revenue cycle.

Revenue Cycle Optimized
The Human Edge in an Automated Revenue Cycle

Revenue Cycle Optimized

Play Episode Listen Later Apr 29, 2025 33:52


Evan Martin of ZoomCare joins us to explore the intersection of automation and expertise in RCM, offering practical insights into denial management, data usage, and building smarter revenue cycle strategies.Brought to you by www.infinx.com

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Litigation Strategies In Pathology RCM On this second installment of our pathology RCM series, we take a high-level look at a topic many practices avoid until it's too late—litigation as a strategic tool to protect and recover revenue. With decades of experience supporting pathology groups, David Smith, COO of MedReceivables Advisor, returns to guide us through the legal considerations that come into play when reimbursement efforts stall. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Monitor Mondays
Audit Alert: Immigration in Healthcare

Monitor Mondays

Play Episode Listen Later Apr 28, 2025 29:58


Nearly every day, on any news service, images of people being quickly led away is chilling as the current Administration continues its sweep of rounding up and deporting suspected illegal immigrants.Thus, in this current climate of increased audits, investigations and scrutiny on immigration, it is essential that healthcare organizations sponsoring foreign nationals for employment, ensure that documentation, policies, and practices are updated and fully compliant.During the next live edition of the venerable Monitor Mondays live Internet radio broadcast, seasoned immigration attorney Matthew Webster will walk you through such essential issues as H-1B visas, L-1 visas and employment-based green cards. Webster is also expected to report on requirements from the Department of Labor (DOL) and the United States Citizenship and Immigration Services (USCIS).Webster, senior immigration attorney at the law firm of Fredrikson & Byron, will discuss the impact of material changes when H-1B amendments are required.The long-running broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Matthew Albright, chief legislative affairs analyst for Zelis, will report on congressional action taking place in Washington, D.C.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: How AI Can Improve Performance Leveraging RCM Benchmarks

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Apr 22, 2025 24:20


How AI Can Improve Performance Leveraging RCM Benchmarks Stuart Newsome, VP of RCM Insights, breaks down the fundamentals of benchmarking in revenue cycle management, including key metrics like net days in A/R and clean claim rates. Learn how AI and automation tools can help healthcare organizations go beyond analytics to drive performance, identify gaps, and enable continuous improvement. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Monitor Mondays
FY 2026 IPPS: Hospital Strategy for Risk Adjustment, Equity, and Reimbursement

Monitor Mondays

Play Episode Listen Later Apr 21, 2025 29:20


The fiscal year (FY) 2026 Inpatient Prospective Payment System (IPPS) proposed rule introduces significant reforms to hospital reimbursement, risk adjustment, and performance measurement.Key changes include the Centers for Medicare & Medicaid Services (CMS) transition to HCC Version 28, the use of the Community Deprivation Index (CDI) for socioeconomic risk adjustment and expanded inclusion of Medicare Advantage data in quality metrics.Launching in 2026, the proposed rule mandates episode-based payments with enhanced pricing accuracy. Hospitals must adapt by updating financial models, realigning quality strategies, and fostering cross-departmental collaboration. These changes emphasize equity, accountability, and transparency, all of which is designed to help in the positioning hospitals to lead in a value-driven healthcare environment.Strategic readiness is critical to thrive under IPPS 2026. Reporting this story, during the next live edition of Monitor Mondays, will be the broadcast's special guest Penny Jefferson.The long-running broadcast will also include these instantly recognizable features:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Folana Houston, senior government affairs liaison for Zelis, will report on congressional action taking place in Washington, D.C.• News Update: Dr. Drew Update will have an update to his recent reporting on transgender treatment practices.

AMA COVID-19 Update
New physician orientation: Hospital orientation for doctors and physician onboarding topics

AMA COVID-19 Update

Play Episode Listen Later Apr 18, 2025 11:47


How to onboard a new physician: What does hospital orientation consist of? How long is orientation at a hospital? How much does physician onboarding cost? The challenges of onboarding new doctors and advice for physician onboarding training with Susan Slaughter, director of physician relations and practice development at Hattiesburg Clinic. American Medical Association CXO Todd Unger hosts.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: AI Automation Drives RCM Workflow Optimization and Denial Analytics

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Apr 16, 2025 17:22


AI Automation Drives RCM Workflow Optimization and Denial Analytics Christina Harkins breaks down how AI-powered automation and analytics are reshaping revenue cycle workflows. From identifying coding errors and denial trends to prioritizing high-impact claims, she explains how ARDM helps teams work smarter, not harder. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Monitor Mondays
HHS, CMS Latest Apparent Battlegrounds for Social Wars Being Waged by Trump Administration

Monitor Mondays

Play Episode Listen Later Apr 14, 2025 30:38


A flurry of national news reports continues to document the large-scale restructuring taking place at the U.S. Department of Health and Human Services (HHS), where 10,000 jobs were reportedly slashed earlier this month, a move also impacting the workforce at the Centers for Medicare & Medicaid Services (CMS). An estimated 300 CMS workers are expected to be affected by this action, while NPR reported that the HHS teams focusing on sexual violence prevention were also eliminated – on the first day of April's Sexual Assault Awareness Month.Also recently, RACmonitor and Monitor Mondays have come into possession of a CMS memo, dated March 5, in which the agency warns that it may take action to prevent hospitals and other providers suspected of using “dangerous chemicals and surgical mutilation of children” relative to gender dysphoria, which the agency claims have “proliferated.” In fact, other executive actions taken by the Trump Administration also appear to have anticipated deleterious impacts on the health of America's LGBTQ+ population.It seems part of an overarching theme in which the Administration is waging social wars using gutted federal agencies more as a weaponized tactic than as a mechanism to serve the public.Reporting this story during the next live edition of Monitor Mondays will be physician Drew Updike, a recognized leader in hospital utilization management, denials, clinical documentation integrity (CDI), coding, and hospital operations.The long-running broadcast will also include these instantly recognizable features:• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Adam Brenman, senior government affairs liaison for Zelis, will report on congressional action taking place in Washington, D.C.• Monday Rounds: Dr. Shaemarke Magan, medical director for CaroMont Health in Gastonia, North Carolina, will make his Monday rounds, substituting for Dr. Ronald Hirsch.

Becker’s Healthcare Podcast
Dr. Kemberly Blackledge, Chief Revenue Cycle Officer at Nashville General Hospital

Becker’s Healthcare Podcast

Play Episode Listen Later Apr 12, 2025 17:09


In this episode, Dr. Kemberly Blackledge, Chief Revenue Cycle Officer at Nashville General Hospital, shares insights into how the hospital is advancing health equity through innovative programs, EHR modernization, and strategic partnerships—while tackling challenges like inflation, funding cuts, and federal regulation to ensure long-term sustainability.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: Adapting, Restructuring, and Thriving in the AI Workforce Shift

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Apr 8, 2025 28:56


Adapting, Restructuring, and Thriving in the AI Workforce Shift AI isn't replacing healthcare revenue cycle professionals—it's reshaping their roles. In this episode, Lavonne Hamby, Client Services Manager at Infinx, joins us to explore how AI is impacting job structures, workforce adaptation, and accountability. Learn how to work alongside AI while maintaining control and maximizing efficiency in revenue cycle operations. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen/

Monitor Mondays
Caught in the Crossfire: How to Avoid Pay-and-Chase Enforcement Tactics

Monitor Mondays

Play Episode Listen Later Apr 7, 2025 31:29


A recent case, United States v. Junyi Liu, reveals how a $23 million fraud scheme exemplifies vulnerabilities in America's healthcare system – as you'll discover when senior healthcare analyst Frank Cohen joins the next Monitor Monday broadcast.You'll also learn about the challenges legitimate providers face when navigating complex regulations – and more about the government's aggressive “pay-and-chase” enforcement tactics, plus why innocent practitioners often get caught in the crossfire.During the next live edition of the venerable weekly Internet broadcast, Cohen will also report on potential policy reforms.The long-running broadcast will also include these instantly recognizable features:• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Adam Brenman, senior government affairs liaison for Zelis, will report on congressional action taking place in Washington, D.C.• Monday Rounds: Dr. Bonney Olney, director of Level of Care Service for R1 RCM, will make her Monday rounds, substituting for Dr. Ronald Hirsch.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: Key Considerations For Clinical Pathology Billing, Coding, And Collections

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Apr 2, 2025 27:38


Key Considerations For Clinical Pathology Billing, Coding, And Collections Learn how to adapt to changing managed care rates and avoid common pathology coding errors that impact your bottom line. Understand the steps needed to ensure your practice gets paid accurately and on time with COO, MedReceivables Advisor David Smith. Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

Monitor Mondays
Wound Care: An Open Source for Audits

Monitor Mondays

Play Episode Listen Later Mar 31, 2025 29:56


No matter the approach one might take for debridement, wound care continues to be an attractive source for audits – they inevitably arise and fester. Case in point: Wachler and Associates, a prestigious law firm in Michigan, currently is representing clients in some 18 wound care audit cases.That is why RACmonitor, producers of Monitor Mondays, has invited Andrew “Drew” Wachler, founder of Wachler & Associates, to be the special guest during the next live edition of the venerable weekly Internet broadcast.The long-running broadcast will also include these instantly recognizable features:• Breaking News: Famed whistleblower attorney Mary Inman, partner at Whistleblower Law, will report about a False Claims Act (FCA) settlement involving a Medicare Advantage provider.• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors.• Legislative Update: Cate Brantley, senior government affairs liaison for Zelis, will report on congressional action taking place in Washington, D.C.• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.

Revenue Cycle Optimized
RCM Insights Making Data Actionable for Revenue Cycle Optimization

Revenue Cycle Optimized

Play Episode Listen Later Mar 24, 2025 12:02


Unlock the power of actionable data in revenue cycle management. Jason Adams, President of Ni2, an Infinx company, shares how AI-driven analytics, customized dashboards, and expert-driven clinical appeals can transform financial performance, enhance transparency, and ensure claims get paid.

Becker’s Healthcare Podcast
Mike Vigo, Chief Revenue Cycle Officer at UC San Diego Health

Becker’s Healthcare Podcast

Play Episode Listen Later Mar 20, 2025 15:51


In this episode, Mike Vigo, Chief Revenue Cycle Officer at UC San Diego Health, shares insights on leadership, technology adoption, and financial strategies in healthcare. Drawing from his military background, he discusses how teamwork, data-driven decision-making, and AI-driven innovation are shaping the future of revenue cycle management.

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More
Revenue Cycle Optimized: RCM Efficiency with AI Agents and Advanced Document Capture Solutions

HealthcareNOW Radio - Insights and Discussion on Healthcare, Healthcare Information Technology and More

Play Episode Listen Later Mar 19, 2025 16:33


Enhancing RCM Efficiency with AI Agents and Advanced Document Capture Solutions Join host Stuart Newsome for an Office Hours session as we explore how AI-powered document capture and AI agents are eliminating documentation bottlenecks, reducing manual data entry, and improving claim accuracy across healthcare specialties. Learn how AI is transforming RCM efficiency for radiology, labs, PT/OT, cardiology, and more! Find all of our network podcasts on your favorite podcast platforms and be sure to subscribe and like us. Learn more at www.healthcarenowradio.com/listen

The Dental Hacks Podcast
Very Dental: Embracing AI in Dentistry with Preet Sandhu

The Dental Hacks Podcast

Play Episode Listen Later Mar 7, 2025 25:28


AI is rapidly transforming the dental industry, offering numerous opportunities for efficiency and improved patient care. Alan talked with Preet Sandhu at the recent Chicago Midwinter Dental meeting about some used of AI in dentistry that you may not have thought of.  Preet is the CEO of ViralKraft (an honest marketing company) as well as StafGo Health, which focuses on the revenue cycle in the dental office. Preet has extensive background in finance and marketing, including 18 years in corporate finance and experience with healthcare finance. The conversation is a deep dive into how AI is revolutionizing dental practices, from marketing and revenue cycle management to patient care and diagnosis.  Key Takeaways: The Integration of Marketing and Revenue Cycle Management: How these two aspects of a dental practice are interconnected. The benefits of separating them into distinct companies. Marketing in Modern Dentistry: The shift from traditional family practices to more specialized dental services. The importance of tailored marketing strategies based on demographics and location. The increasing role of AI in personalizing marketing campaigns. AI Applications in Dentistry: Content creation, including blogs and show notes. Analysis of patient data to personalize treatment and marketing. Streamlining billing and insurance verification processes. Assisting in diagnosis through the analysis of radiographs and other medical images. AI tools for note taking, and meeting summaries. Ethical Considerations of AI in Healthcare: The importance of transparency and patient consent when using AI tools, especially for recording patient interactions.   The balance between leveraging AI for efficiency and maintaining the human touch in patient care. Some links from the show: Viralkraft StafGo  Join the Very Dental Facebook group using the password "Timmerman," Hornbrook" or "McWethy," "Papa Randy" or "Lipscomb!" The Very Dental Podcast network is and will remain free to download. If you'd like to support the shows you love at Very Dental then show a little love to the people that support us! -- Crazy Dental has everything you need from cotton rolls to equipment and everything in between and the best prices you'll find anywhere! If you head over to verydentalpodcast.com/crazy and use coupon code “VERYDENTAL10” you'll get another 10% off your order! Go save yourself some money and support the show all at the same time! -- The Wonderist Agency is basically a one stop shop for marketing your practice and your brand. From logo redesign to a full service marketing plan, the folks at Wonderist have you covered! Go check them out at verydentalpodcast.com/wonderist! -- Enova Illumination makes the very best in loupes and headlights, including their new ergonomic angled prism loupes! They also distribute loupe mounted cameras and even the amazing line of Zumax microscopes! If you want to help out the podcast while upping your magnification and headlight game, you need to head over to verydentalpodcast.com/enova to see their whole line of products! -- CAD-Ray offers the best service on a wide variety of digital scanners, printers, mills and even  their very own browser based design software, Clinux! CAD-Ray has been a huge supporter of the Very Dental Podcast Network and I can tell you that you'll get no better service on everything digital dentistry than the folks from CAD-Ray. Go check them out at verydentalpodcast.com/CADRay!