Podcasts about revenue cycle

In this episode, Erin Hodson, MSN, Vice President of Revenue Cycle at Inova Health, shares how emerging AI tools, evolving team skill sets, and new patient financial needs are reshaping denials management, operational strategy, and the overall revenue cycle experience.

AI Oversight for the Modern Revenue Cycle As AI agents take on more decisions across the revenue cycle, the question isn't how fast automation can move — it's how safely it operates. This session explores the guardrails of governance in an AI-driven RCM environment, outlining practical steps to ensure transparency, compliance, and human accountability as automation scales. 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/

Prior authorization in oncology is notoriously complex, with aggressive payer policies and documentation hurdles that delay care. Join Liz Durkin, Manager of Revenue Cycle from Exact Sciences, as she shares challenges faced before Infinx, improvements since partnering, and how automation and programmatic strategies are reshaping their PA workflows.Brought to you by www.infinx.com

As many healthcare organizations seek to optimize revenue cycle management, Ensemble offers a reasoning-driven agentic AI approach that can speed up appeals, reduce denials and recover lost revenue. Learn how Ensemble connects clinical data, financial data and human insight to solve revenue cycle problems in real time. 

In this episode, Lindsay Myers, MBA, MPH, Vice President of Revenue Cycle and HIM at Chapters Health System, discusses how her organization is scaling operations, leveraging automation, and investing in people to support rapid growth and long-term financial stability across its nationwide hospice and value-based care network.

In this episode, Lindsay Myers, MBA, MPH, Vice President of Revenue Cycle and HIM at Chapters Health System, discusses how her organization is scaling operations, leveraging automation, and investing in people to support rapid growth and long-term financial stability across its nationwide hospice and value-based care network.

Reverification Leads to Prior Authorization Automation Live Demo Reverification can uncover coverage changes that require new prior authorizations. In this live demo, we'll show how intelligent automation and AI agents determine when an authorization is needed, initiate it automatically, and keep the process moving without disrupting staff or patient care. 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

In this episode, Shari Johnson, Chief Revenue Cycle Officer at Alameda Health System, discusses how the health system leverages AI, automation, and data-driven strategies to streamline revenue cycle operations while empowering staff and improving patient care. She shares insights on overcoming industry challenges, fostering employee engagement, and leading organizational change.

Send us a textWhat if I told you that in most medical groups, the person in charge of your financial health might not fully understand half of your revenue?It sounds dramatic, but it's true. In countless physician practices and medical groups across the country, the CFO—the Chief Financial Officer—is responsible for the organization's entire financial picture… except when it comes to revenue cycle. That part? That's usually considered operations. Or billing. Or someone else's responsibility.The problem is, revenue cycle represents money in—the very top of the financial funnel. So if your CFO isn't actively overseeing how revenue is earned, coded, billed, collected, and followed up on… then who is? And more importantly, what is it costing you?Today we're going to explore the hidden—but very real—disconnect between Finance and Revenue Cycle in medical groups. We'll talk about how this structural divide came to be, what it costs you in real dollars, and what you can do to fix it. If you're a physician leader, an administrator, a CFO, or a board member, this episode is for you. Because it's time to bridge the gap—and start treating revenue cycle as a core part of financial strategy.Please Follow or Subscribe to get new episodes delivered to you as soon as they drop! Visit Jill's company, Health e Practices' website: https://healtheps.com/ Subscribe to our newsletter, Health e Connections: http://21978609.hs-sites.com/newletter-subscriber Want more formal learning? Check out Jill's newly released course: Physician's Edge: Mastering Business & Finance in Your Medical Practice. 32.5 hours of online, on-demand CME-accredited training tailored just for busy physicians. Find it here: https://healtheps.com/physicians-edge-mastering-business-finance-in-your-medical-practice/ Purchase your copy of Jill's book here: Physician Heal Thy Financial Self Join our Medical Money Matters Facebook Group here: https://www.facebook.com/groups/3834886643404507/ Original Musical Score by: Craig Addy at https://www.underthepiano.ca/ Visit Craig's website to book your Once in a Lifetime music experience Podcast coaching and development by: Jennifer Furlong, CEO, Communication Twenty-Four Seven https://www.communicationtwentyfourseven.com/

In this episode, Keisha Downes, MBA-HM, RN, CCDS, CCS, Vice President of Mid-Revenue Cycle at Beth Israel Lahey Health, discusses the rapid evolution of AI and automation in revenue cycle management, the shift toward proactive claim processing, and how technology and teamwork are helping streamline operations and strengthen financial performance across the system.

This episode features John Polikandriotis, CEO of South Florida Orthopaedics & Sports Medicine, who shares how reimagining revenue cycle management as both a shield and a sword can drive organizational growth. He discusses the power of data transparency, cross-department collaboration, and patient-centered access models in building a more agile, innovative, and financially strong healthcare organization.This episode is sponsored by NextGen Healthcare.

This episode features John Polikandriotis, CEO of South Florida Orthopaedics & Sports Medicine, who shares how reimagining revenue cycle management as both a shield and a sword can drive organizational growth. He discusses the power of data transparency, cross-department collaboration, and patient-centered access models in building a more agile, innovative, and financially strong healthcare organization.This episode is sponsored by NextGen Healthcare.

Reverification season creates a tsunami of eligibility checks and payor changes. In this live demo, we showed how automation in EVB reduces bottlenecks, cuts denials, and supports staff during the busiest time of year. 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/

On this episode of The Digital Patient, Dr. Joshua Liu, Co-founder & CEO of SeamlessMD, and colleague, Alan Sardana, chat with Dr. Mark Mabus, Chief Medical Informatics Officer and Senior Vice President of EHR, Clinical and Revenue Cycle at Parkview Health, about everything "From Escape-Room Training to TikTok-style Edutainment, Infusing Creativity into Healthcare IT Training, Preparing Clinicians for the Future of the EHR, and more..."

Fans of Off the Record may recall my recent episode with Chris Petrilli, Director of Revenue Cycle of Operations at NYU Langone, who joined me to discuss his experience delivering a TEDx Talk on artificial intelligence. Chris was well prepared and delivered a great lecture, which you should definitely check out on YouTube. And on the podcast he sang the praises of a coach brought in to prep him and other NYU Langone staff for the big day on the big stage. My wheels started to spin, I reached out... and landed that coach for OTR.  Susanna Baddiel is an actress, director, voice over artist and TEDx Speaker Coach. She works in both the UK and the US and is a founder member of Actors Shakespeare Company where she continues to act, direct and coach. She has more than 17 years of experience teaching public speaking, personal impact, presentation skills, leadership development, and executive coaching. It was my honor to host her in a bit of an offbeat show than the usual mid-revenue cycle topics. But I picked up a few pointers about public speaking that helped me, and I think you will too. This special episode kicks off November, a month in which I'll be taking a deep delve into provider engagement. Odds are if you're trying to engage providers you'll have to present or educate, and Susanna offers some great advice and practical tips and takeaways. On this show we cover: Her background as an actress in Britain, transition into coaching, and eventually working with niche clients in science and medicine Working with the team at NYU and Chris Petrilli—preparing them, building them up, and getting them ready for the big day. Why preparation is everything in public speaking, as is gratitude for the opportunity Balancing authenticity vs. general principles of good presentation The differences between in-person and presenting on camera. Susanna offers some GREAT suggestions for being better on Zoom. Books and other resources Susanna recommends 

Smart PT Reverification Lessons From Mary Free Bed On this episode, hear from Mary Free Bed's Daniel Heemstra on overcoming PT reverification challenges, supported by intelligent automation and Epic integration that simplify the process and reduce the burden on staff. 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/

As AI agents take on more decisions across the revenue cycle, the question isn't how fast automation can move — it's how safely it operates. This session explores the guardrails of governance in an AI-driven RCM environment, outlining practical steps to ensure transparency, compliance, and human accountability as automation scales.Brought to you by www.infinx.com

Imagine a world where every step of patient care and the revenue cycle work together in a faster, smarter way, and where documentation is generated from what is said during the encounter, and is complete and compliant, with real-time, autonomously coded claims. Our ambition is to reduce your revenue cycle workload by at least 50% by 2027, while, at the same time, dramatically improving revenue cycle outcomes. It's about taking more work off your plate than we ever thought possible.  This episode is brought to you by Pretty Good AI: https://marketplace.athenahealth.com/product/pretty-good-ai

Region 9 HFMA: The Anatomy of AI Agents - What They Are, How They Work, and Why They Matter AI agents don't come with arms, legs, or eyes—but they do have something even better: the ability to think, reason, and act. As generative AI continues to evolve, so do the capabilities of AI agents—autonomous systems that can interact with applications, extract and apply knowledge, and make decisions based on context. 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/

Navaneeth Nair, Chief Product Officer at Infinx, explains how AI and automation are reshaping the revenue cycle by creating seamless collaboration between people and intelligent agents. He describes a pragmatic roadmap where technology takes on more work autonomously without removing the human expertise that keeps healthcare operations moving.

Ensuring Quality and Compliance in AI Coding Explore how today's AI-powered coding solutions are designed with compliance and quality at their core. This episode will highlight the safeguards built into implementation, the auditing processes that protect accuracy, and how continuous improvement ensures models evolve over time. Join us to learn how organizations can confidently adopt AI while maintaining trust, compliance, and coding excellence. 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/

In this episode, Abigail Abongwa, MHA, System Vice President of Revenue Cycle at UW Health, joins the podcast to discuss how technology, data analytics, and patient-centered strategies are reshaping revenue cycle management. She shares insights on tackling financial pressures, improving patient financial experiences, and preparing teams for a tech-enabled future.

Bringing the Human Touch Back to AI Revenue Cycle Transformation AI may be the buzzword of the decade, but its success depends on something far older—human connection. Join healthcare leader Nio Queiro for a candid discussion on demystifying AI, building trust across teams, and turning innovation into lasting operational change. 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 revenue cycle helps keep hospital revenue flowing. But sometimes, it seems to sputter out, as if not all the cylinders are firing. And that is why the producers of Talk Ten Tuesdays have invited longtime ICD10monitor editorial consultant Dennis Jones, senior director of revenue cycle at the famed Jefferson Health, to be the special guest during the next live edition of the weekly Internet radio broadcast.The popular broadcast will also feature these instantly recognizable panelists, who will report more news during their segments:• CDI Report: Cheryl Ericson, Senior Director of Clinical Policy and Education for the vaunted Brundage Group, will have the latest clinical documentation integrity (CDI) updates.• 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.

In this episode, Abigail Abongwa, MHA, System Vice President of Revenue Cycle at UW Health, joins the podcast to discuss how technology, data analytics, and patient-centered strategies are reshaping revenue cycle management. She shares insights on tackling financial pressures, improving patient financial experiences, and preparing teams for a tech-enabled future.

Recently, a federal court vacated the Centers for Medicare & Medicaid Services 2023 Risk Adjustment Data Validation (RADV) Final Rule.This action is reshaping the landscape for Medicare Advantage compliance. The rule had authorized contract-level extrapolation and eliminated the longstanding fee-for-service (FFS) adjuster — two changes that dramatically increased the potential scale of overpayment recoveries.Reporting this developing story during the next live edition of Monitor Monday will be senior healthcare analyst Frank Cohen,The weekly 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 legislative affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

In this episode, Sarah E. Ginnetti, Chief Revenue Cycle Officer and VP of Clinical Revenue at UConn Health, discusses her top priorities, the role of AI and analytics in revenue cycle management, and how collaboration across clinical, finance, and strategy teams is shaping the future of healthcare operations.

In this episode, Sarah E. Ginnetti, Chief Revenue Cycle Officer and VP of Clinical Revenue at UConn Health, discusses her top priorities, the role of AI and analytics in revenue cycle management, and how collaboration across clinical, finance, and strategy teams is shaping the future of healthcare operations.

The Realities of Reverification and the Future of Intelligent Automation AI is everywhere in healthcare conversations, but when it comes to reverification, the reality is more complex. Each January, practices are hit with a surge of eligibility and benefits checks, straining staff and creating bottlenecks that risk revenue and patient experience. Traditional fixes like staff augmentation and manual workflows keep the lights on, but they don't solve the underlying scalability problem. In this Office Hours, Jonathan Aguiar, Senior Solutions Engineer, and Lora Pada, AVP of Customer Success, will break down the real-world challenges of reverification, explore how staff augmentation and partial automation fill today's gaps, and discuss how intelligent automation and AI agents are being developed to change what's possible tomorrow. 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/

A recent case filed by the U.S. Department of Justice (DOJ) reveals how an insider was able to detect fraud in a large managed care organization (MCO).Although the topic of medical loss ratio (MLR) might be arcane to some, when the subject involves millions of dollars of potential fraud, it quickly becomes a large blip on the government's fraud detection radar.More on this topic will be reported during the next live edition of Monitor Mondays. That's when whistleblower attorney Max Voldman returns to the long-running Internet broadcast to report on how a payer, Inland Empire Health Plan, miscalculated its MLR in a scheme to rebate less money to the government than to which it was legally obligated.The weekly 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 legislative affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

Manual intake workflows are one of the biggest slowdowns in healthcare. Every day, staff spend hours chasing down documents, retyping data, or figuring out what's missing—before a patient can even be scheduled. In this episode, Stuart Newsome, VP of RCM Insights at Infinx, shows how agentic AI can change that. 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/

AI may be the buzzword of the decade, but its success depends on something far older—human connection. Join healthcare leader Nio Queiro for a candid discussion on demystifying AI, building trust across teams, and turning innovation into lasting operational change.Brought to you by www.infinx.com

More management and insurance knowledge in my newsletter: https://www.odysseymgmt.com/newsletter   Lessons Patients Taught Me The Hard Way   Some of the most powerful lessons in dentistry don't come from textbooks or training, but from real-life patient encounters that test your patience, humility, and adaptability. In this episode, I reflect on situations where patients pushed me out of my comfort zone and forced me to grow in ways I didn't expect. You'll hear how these interactions shaped my approach to communication, accountability, and practice management. More importantly, you'll discover why it's okay when patients don't connect with you and how to manage tough patient personalities. These aren't just stories to make you laugh; they're lessons to help you navigate the unpredictable world of patient care with confidence. Connect with Teresa   Website: https://www.odysseymgmt.com/ Email: teresa@odysseymgmt.com Instagram: treeduncan Facebook: Odyssey Management Dental Speaking & Consulting LinkedIn: Teresa Duncan, MS   ------------- Have you ever wondered what career opportunities in dentistry exist beyond clinical care? Whether you're a dentist, hygienist, assistant, or manager, this full-day, in-person workshop is your chance to explore new paths in speaking, coaching, consulting, and more. Join Teresa and Angela on March 6th 2026  in Northern Virginia. Limited to just 20 attendees. Registration is open. Secure your spot today:

Hospitals are juggling shrinking margins and rising costs while denial volumes remain stubbornly high. In the revenue cycle alone, hundreds of billions are lost annually to preventable errors and inefficiencies—in fact, Access Healthcare CEO Shaji Ravi cites more than $250 billion wasted each year. Meanwhile, payers have accelerated their use of AI to adjudicate and deny claims. Against this backdrop, a practical question has turned urgent: can health systems modernize fast enough without derailing day-to-day cash flow?What would it take to deploy AI across the revenue cycle without a painful rip-and-replace—and actually cut operating costs by half?On this episode of Highway to Health, host David Kemp talks with Shaji Ravi, the CEO of Access Healthcare, which is now part of Smarter Technologies (alongside SmarterDX and Thoughtful AI). They unpack a blueprint for “transformation without disruption,” covering front-end CDI and coding, mid-cycle automation, and back-end denials/AR—plus the governance needed to keep AI reliable and compliant.Key highlights from the episode...Front-end first: Fix documentation and coding upstream (SmarterDX) to reduce downstream rework; 60% of claims pay cleanly, but the persistent 40% problem starts before submission.Agentic AI with humans-in-the-loop: Move beyond RPA's static rules to self-learning “knowledge streams” that spot root causes, propagate fixes across thousands of claims, and are audited by governance teams—no “rogue bots.”Zero-disruption rollout, real ROI: Wrap modular AI around existing EHRs, require “near-zero” IT lift, and phase savings: ~50% people reduction in the first months as agents take on denial management, coding assists, posting, and AR follow-up.Shaji Ravi has spent nearly 30 years in the U.S. healthcare revenue cycle, beginning in the mid-1990s and ultimately co-founding and scaling Access Healthcare to 27,000+ specialists across the U.S., India, and the Philippines. Now the CEO of Access Healthcare within Smarter Technologies, he's leading the integration of service delivery (Access Healthcare), clinical/front-end intelligence (SmarterDX), and agentic automation (Thoughtful AI) to help providers cut costs and improve collections—without changing core systems.

Rural hospitals don't need another cost-cutting cliché. They need to reclaim what's already theirs. On this episode, Taylor Searfoss from Infinx highlights the hidden dollars buried in hospital workflows—and shows you how to find them. 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

Healthcare compliance just shifted fundamentally.Traditional whistleblowers who needed inside access are being replaced by artificial intelligence (AI)-powered relators who mine public datasets and flag statistical anomalies that could signal fraud.The U.S. Department of Justice (DOJ) logged 979 qui tam cases in 2024, many of which were reportedly triggered by mathematical outliers, rather than insider tips. Government agencies, such as the Centers for Medicare & Medicaid Services (CMS), have already recovered $820 million using algorithmic detection.During the next live edition of Monitor Mondays, senior healthcare analyst Frank Cohen will reveal a possible solution for hospitals, health systems, and physician practices.The weekly 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.

Over 70% of imaging centers still depend on manual referral, scheduling, and prior auth processes—slowing care and straining staff. In this episode, Stuart Newsome, CPCO, VP of RCM Insights at Infinx, shows how AI agents powered by generative AI are transforming radiology operations. See how these “invisible coworkers” integrate with RIS, PACS, and EHRs to automate tasks, improve efficiency, and deliver real 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/

Consider this a wake-up call.As artificial intelligence (AI) quietly becomes part of the audit trail, healthcare leaders must ask a new question: who's reviewing the reviewers?During the next live edition of the venerable Monitor Mondays broadcast, contributing editor Sharon Easterling will break down why auditing AI tools are no longer a tech issue – they're a documentation integrity and compliance priority.Although this is an important topic for all healthcare professionals, register now to learn why it's particularly relevant for those in compliance and revenue integrity.The weekly 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 government affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

S3E9: What's Trending NOW is how a smarter revenue cycle empowers better care. On this episode host Shahid Shah is joined by Rob Stuart, CEO of Claim.MD, a leading EDI Clearinghouse, providing innovative, affordable electronic claims management solutions that streamline billing and boost cash flow for healthcare providers. Rob shares insights on the strategic role of revenue cycle and where payer go wrong. Additionally why getting claims right the first time is now a front-line clinical priority, and how technology, infrastructure, and payer-provider collaboration can drive value-based care. To stream our Station live 24/7 visit www.HealthcareNOWRadio.com or ask your Smart Device to “….Play Healthcare NOW Radio”. 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

How Radiology Teams Modernize Intake Without Disrupting Epic Workflows Modernizing radiology intake means more than sending documents to Epic—it's about building accuracy into the process. Learn how AI-powered document capture uses HL7 ORM mapping to handle multi-patient faxes, duplicates, and poor-quality images, with a phased rollout that keeps data clean and workflows running smoothly. 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/

Closing the Visibility Gap in Patient Access Metrics Many hospitals lack real-time visibility into front-end revenue cycle metrics like prior auth status and registration accuracy. This episode explores how closing that visibility gap can reduce denials, improve staff performance, and drive better financial outcomes. 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

Send us a textWelcome to the Medical Money Matters Podcast, brought to you by Health e Practices—where we explore smarter ways to manage the business side of medicine, without losing sight of why we're here: to provide excellent care.Today's episode might make you a little uncomfortable—and that's a good thing. We're talking about revenue that slips through your fingers every single day. And here's the truth: if you're not watching your revenue cycle closely, you're very likely seeing patients for free and you don't even know it.That's not hyperbole. We've seen it over and over again: practices losing thousands, even hundreds of thousands of dollars annually because of small breakdowns—some of which happen before the patient even walks through the door. Today, we're going to track down where your money might be hiding, and more importantly, how to keep losing money in the future.Please Follow or Subscribe to get new episodes delivered to you as soon as they drop! Visit Jill's company, Health e Practices' website: https://healtheps.com/ Subscribe to our newsletter, Health e Connections: http://21978609.hs-sites.com/newletter-subscriber Want more formal learning? Check out Jill's newly released course: Physician's Edge: Mastering Business & Finance in Your Medical Practice. 30+ hours of online, on-demand training tailored just for busy physicians. Find it here: https://healtheps.com/physicians-edge-mastering-business-finance-in-your-medical-practice/   Purchase your copy of Jill's book here: Physician Heal Thy Financial Self Join our Medical Money Matters Facebook Group here: https://www.facebook.com/groups/3834886643404507/ Original Musical Score by: Craig Addy at https://www.underthepiano.ca/ Visit Craig's website to book your Once in a Lifetime music experience Podcast coaching and development by: Jennifer Furlong, CEO, Communication Twenty-Four Seven https://www.communicationtwentyfourseven.com/

In anticipation of the 2025 ASHP Conference for Pharmacy Leaders, ASHP is hosting a series of podcast episodes. Join our host, Cynthia Von Heeringen, senior education director at ASHP, as she interviews Venessa Goodnow, assistant vice president and chief pharmacy officer at Jackson Health System, as she discusses her upcoming sessions, Tackling the Revenue Cycle Challenge: Processes, Politics, Payers, and Patients.  The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

The Unified Program Integrity Contractors (UPICs) are household names in healthcare compliance.But their track record tells a troubling story, according to senior healthcare analyst Frank Cohen. These Medicare fraud enforcement contractors are using controversial extrapolation techniques that providers successfully challenge over 60 percent of the time on appeal.Cohen, who will be the special guest during the next live edition of Monitor Mondays, said he will examine how the 2016 consolidation created five regional enforcement powerhouses, along with why their statistical methodologies are devastating practices based on flawed assumptions. Cohen intends to show how misaligned incentives are creating systematic accuracy problems, while revealing why the current UPIC system might be fundamentally broken, despite everyone agreeing that fraud prevention matters.The weekly 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 affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

From Prior Authorization Chaos to Clear AI Orchestration Prior authorization isn't just broken — it's unsynchronized. On this episode, Evan Martin, VP of Revenue Cycle Management at ZoomCare Inc as well as Host and Producer of The Wilshire's IT RevCast, shares what happens when real-time care delivery meets a fragmented, rule-heavy prior auth system that can't keep up. With just one authorization specialist covering 50 clinics, Evan paints a clear picture: today's healthcare moves fast, but prior auth is still stumbling through a maze of plan-specific rules, outdated workflows, and underperforming automation tools. We explore how even routine imaging, meds, and mental health services become tangled in conflicting payer policies and benefit silos. Evan breaks down the bottlenecks, the firefighting, and the policy blind spots — plus why simply layering automation on top won't fix it. The real opportunity? An orchestrated model powered by agentic AI triages, retrieves, and routes the right information to the right place — so human teams can actually focus on patient care. This isn't theory. It's the lived complexity of treating patients while waiting for permission — and what the future could look like if we finally got the process in tune. 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

There just might be a reign of terror being experienced at many of America's hospitals and health systems. Professionally delivered patient care apparently seems to be getting hijacked by auditors compelled to deny claims of omission.Aided by the Centers for Medicare & Medicaid Services (CMS) and abated by auditors private and public, the lingua franca appears be an entanglement of descriptors, namely “inpatient versus outpatient.”During the next live edition of the venerated Monitor Monday broadcast, several of the most recognized names in healthcare will not add to the confusion, but offer advice for those on the front lines of battle.The weekly 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.

Radiology groups face mounting pressure to maintain payer alignment, grow their footprint, and stay financially viable—but often, one of the most critical operational functions is still stuck in the shadows: credentialing. Join Rebecca Bairnsfather and Peggy Kelly—two industry veterans now part of the Infinx family—for a candid, behind-the-scenes look at why credentialing and enrollment processes are breaking down under the weight of today's complexity. With experience managing credentialing operations for thousands of providers across multiple states, they'll share real stories, actionable strategies, and a no-fluff assessment of the tools, tech, and expectations that define this often-overlooked function. 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

CMS is rolling out prior authorization for traditional Medicare. This Office Hours panel breaks down what the WISeR model means for providers, how AI is involved, and what steps to take now—whether you're in a test state or watching for what's next. 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

Faxed orders, scanned attachments, and inbox folders shouldn't be the reason prior authorizations are delayed. Yet for many radiology groups, that's still the case. Manual document capture creates friction at the front of the process—forcing staff to rename, sort, and route incoming faxes before a prior auth can even begin. In this episode, we explore how automating document capture accelerates the entire prior authorization workflow. From identifying STAT orders to extracting key order details and triggering auth submissions, we'll walk through how imaging centers are using AI-driven tools to minimize lag, reduce errors, and scale operations without burning out staff. Joining us is Charulata Nevatia, a healthcare product leader with deep experience in workflow automation. She'll share what high-performing radiology groups are doing differently and what steps you can take to modernize intake and boost auth readiness. 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

In this episode, Sharon Easterling, CEO and VP of Revenue Cycle at Upskillz, discusses AI's growing impact on healthcare, the need for upskilling in an evolving workforce, and her development of “Shakira,” an AI solution designed to transform the revenue cycle. She also shares powerful advice for leaders navigating the future of care and technology.