Podcasts about revenue cycle

The rugged audit landscape has changed – and not for the better.Today, there are more potential pitfalls and traps to capture the unprepared and impact them with huge fines and possible incarceration. In fact, the Centers for Medicare & Medicaid Services (CMS) has erected a legal fortress to protect their audit process. It's not the same old ballgame – it's a new one, with lots of new players.It's also why the producers of Monitor Mondays have invited senior healthcare analyst Frank Cohen to return to the broadcast to describe how you and your team can learn how to identify red flags in the process of fraud detection in order to avoid liability.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 healthcare government affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

Send us a textJoin me for a compelling conversation with national subject matter expert on Revenue Cycle for medical groups, Taya Gordon, MBA, FACMPE, CMOM. She outlines how the revenue cycle department in each clinic needs to come out of the shadows, and into the forefront for physician owners and administrators. We go through why every clinic should have routine "check-ups" for their revenue, or revenue cycle assessments, and exactly what physician owners and leaders should be looking for in that assessment. She gives several high level examples with national benchmarks, and breaks down more of the language of revenue cycle to make it easy for busy physicians to understand.Taya can be reached via LinkedIn at https://www.linkedin.com/in/tayagordon/ and via email at: taya@healtheps.com.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 content? Find sample job descriptions, financial tools, templates and much more: www.MedicalMoneyMattersPodcast.com  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, 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.

Prior Auth Reform Pledge and What Comes Next On June 23, 2025, Health and Human Services Secretary Robert F. Kennedy Jr. and CMS Administrator Dr. Mehmet Oz announced a voluntary pledge from major U.S. health insurers to reform prior authorization (PA) processes. This initiative aims to reduce administrative burdens and improve timely access to care for millions of Americans. On this episode, we delve into the specifics of the announcement, examine the historical context of prior authorization reforms, and discuss the real-world implications for healthcare providers and patients. We'll also explore how these changes align with ongoing conversations we're having with clients and what steps providers can take to prepare for the evolving landscape. 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 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Proposed Rule for the 2026 fiscal year has been released.Tucked inside the Proposed Rule from the Centers for Medicare & Medicaid Services (CMS) is the agency's recommendation to phase out the Inpatient-Only List (IPO) over the course of the next three years.Reporting the lead story on this development during the next edition of Monitor Mondays will be longtime panelist Ronald Hirsch, MD.The weekly 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.• 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.

Michael welcomes Todd Doze, CEO of Janus Health, to discuss how AI is being introduced to address revenue cycle and operational resilience, how AI supports staff rather than replacing them, and strategies hospitals should consider when entering the AI landscape. 

Managing a coding team in today's revenue cycle landscape is no small task—especially when that team is remote, the claims are complex, and the pressure is high. In this session, Jessica Watson, Facility Coding Manager at Infinx, joins host Stuart Newsome for an unfiltered look at what makes an RCM coding leader effective. Jessica shares how she balances performance metrics with coder wellbeing, builds a culture of transparency and accountability across remote teams, and addresses common pitfalls like documentation ambiguity, productivity burnout, and denial patterns. Jessica breaks down what it really takes to build trust, accuracy, and efficiency in a modern coding department. Whether you're leading a coding team or just want to understand what “good” looks like in the world of facility coding and revenue cycle management, this episode delivers real-world tactics and frameworks you can use today. 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

It's a Medicaid Madness mess.For many years, Medicaid has been providing support for America's most vulnerable populations. But now, Medicaid finds itself as a pawn, being manipulated for political gain between two opposing forces: those who view the program as a means to an end to reduce government spending, and those who hold the opposite point of view.Who will be the winners and losers? During the next live edition of the venerated Monitor Mondays, senior healthcare consultant Dennis Jones will report on how hospitals can save money in the face of the inevitable Medicaid cuts.Jones, senior director of revenue cycle at Jefferson Health, was among the first of hand-picked subject-matter experts heard nearly 14 years ago on the weekly Internet broadcast produced by RACmonitor.The Monday's 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: Sitting in for healthcare attorney David Glaser will be attorney Marguarite Ahman, a shareholder in the law offices of Fredrikson & Byron.• Legislative Update: Matthew Albright, chief legislative affairs analyst for Zelis, will report on the news happening at the intersection of healthcare and congressional action.

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.

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.

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.

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.

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.

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

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

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.

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.

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/

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.

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.

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.

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.

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.

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.

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/

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/

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.

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/

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.

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?

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.

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/

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.

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.

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

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.

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/

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

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.

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.

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.

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

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

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

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.

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

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.

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

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.

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/