POPULARITY
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
In this episode of Leaders in Medical Billing, host Chanie Gluck sits down with Ramesh Gogineni, CEO of Med-Strategies, who shares his entrepreneurial journey from India to the U.S., and how he built a hybrid offshore/onshore medical billing model along the way. Formally an engineer with plenty of operations and tech experience, Ramesh's healthcare career started when he married a physician and decided to set up a company that set up Electronic Health Records (EHRs) and then a billing company. He highlights the challenges of early offshoring, why blending automation with human expertise is critical for success, and the optimal staffing mix for RCM operations today. He also offers practical insights on using RPA, AI, and smart vetting processes to drive efficiency while maintaining quality in Revenue Cycle Management. Listen to this episode to hear first-hand experience from someone who has spent decades experimenting with offshoring medical billing. Plus, Ramesh shares what he's looking forward to in the future of medical billing: improving relationships between payors and providers. You can find out more about Med-Strategies here: https://med-strategies.com/ Sponsored by 4D Global, empowering medical billing companies through offshore staffing, automation, AI and technology.
In this episode, Dr. Vishal P. Rekhala, an interventional pain management specialist, joins us to explore a game-changing approach to launching private medical practices through Independent Practice Partners (IPP). We unpack how IPP helps physicians go from concept to fully operational practice in as little as six months — without the usual red tape and overwhelm. Dr. Rekhala shares how a visionary group of ophthalmologists founded IPP to challenge the status quo and empower doctors to reclaim control of their careers. We discuss how this model is giving new life to private practice, especially at a time when many physicians feel trapped by hospital systems and insurance giants. As consolidation tightens its grip on healthcare, this conversation reveals how IPP offers a path to autonomy, financial growth, and better work-life balance — something many young doctors crave but struggle to achieve. We also spotlight the critical role of medical sales reps in this journey, acting as trusted guides who help physicians navigate the complex terrain of starting and scaling their own practices. From revenue cycle management and regulatory hurdles to the rise of boutique cash-pay practices, this episode is packed with real-world insights for physicians and sales professionals alike. Whether you're a doctor dreaming of independence or a rep looking to expand your impact, this conversation is your roadmap to thriving in today's evolving medical landscape. Connect with Dr. Rekhala: LinkedIn Connect with Me: LinkedIn Love the show? Subscribe, rate, review, and share! Here's How » Want to connect with past guests and access exclusive Q&As? Join our EYS Skool Community today!
In this special segment recorded live at the recent HLTH conference, we explore how combining AI and human expertise is driving measurable ROI across the revenue cycle. John Lynn of Healthcare IT Today sits down with Navaneeth Nair and Lora Pada from Infinx to discuss real-world strategies that balance automation with human oversight.
Why AI Needs to Think for the Future of Revenue Cycle Management Traditional automation in revenue cycle management is no longer enough—healthcare providers need AI that thinks, adapts, and problem-solves. Join Jaideep Tandon, CEO of Infinx, and host Stuart Newsome as they explore the shift from automation to intelligence, the latest industry trends, and how AI is driving denial prevention, smarter prior authorizations, and optimized A/R workflows. Don't miss this insightful discussion on the future of revenue cycle management. 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
Traditional automation isn't enough—AI is the future of revenue cycle management. Join Jaideep Tandon, CEO of Infinx, and Stuart Newsome for a discussion on how AI is transforming denial prevention, prior authorization, and A/R workflows.Brought to you by www.infinx.com
Digital Health Talks - Changemakers Focused on Fixing Healthcare
Join Patty Hayward as she reveals how AI-enabled contact centers are revolutionizing healthcare access and patient engagement. Learn how Talkdesk's technology is bridging critical communication gaps between patients and providers, while delivering more personalized care experiences through intelligent automation.Discover how AI-powered contact centers are solving healthcare access challengesLearn practical strategies for implementing automated, yet personalized patient engagementUnderstand the future of healthcare communication and its impact on patient care deliveryPatty Hayward, GM of Healthcare and Life Sciences, TalkdeskMegan Antonelli, CEO, HealthIMPACT Live
In this episode of Leaders in Medical Billing, Ankit Jain, co-founder and CEO of Infinitus Systems, discusses how AI voice agents are changing the healthcare industry. With a background in AI venture capital investment and experience launching two successful tech startups (including a Google acquisition), Ankit shares how Infinitus is eliminating inefficiencies in billing workflows by automating phone calls for tasks such as benefit verifications, prior authorization checks, and claim status updates. He explains the role of AI co-pilots and AI agents alongside humans, how they improve billing team productivity, and why security and compliance are critical when implementing AI in healthcare. Ankit also provides insights into the future of AI in medical billing, the challenges of scaling AI technology, and how automation can reduce healthcare worker burnout while improving the patient experience. With over five million AI-powered calls handled, Infinitus is already working with some of the largest healthcare organizations to streamline administrative tasks and enhance operational efficiency. Ankit shares insights into the future of AI, including risks and how it can improve our entire healthcare system. Tune in to learn how AI-driven automation is reshaping the medical billing industry and why billing companies should consider adopting a comprehensive voice AI platform. Learn more about Infinitus on their website: https://www.infinitus.ai/ Sponsored by 4D Global, empowering medical billing companies through offshore staffing, automation, AI and technology.
In this episode, Scott Becker sits down with AKASA co-founders Malinka Walaliyadde and Benjamin Beadle-Ryby to discuss the transformative impact of AI on healthcare revenue cycle management. They explore how AKASA leverages generative AI to drive efficiency, improve financial outcomes, and support healthcare staff, while addressing concerns around trust, data integrity, and job displacement.
Send us a textIn this episode of the Advancing Surgical Care Podcast, ASCA Chief Executive Officer Bill Prentice is joined by HST Pathways Chief Executive Officer David Thawley for an in-depth discussion about the company's recently released “State of the Industry Report: Best Practices & Industry Benchmarks for Optimizing ASC Operations.” Prentice and Thawley discuss several of the trends in ASC care and management in 2024, including specializations on the rise, operating room efficiencies, revenue cycle management and a host of best practices that emerged from examining the operational data and reporting of 590 ASCs across 47 states.To access a free copy of the report, visit the HST Pathways website.
AI Agents For Smarter Revenue Cycle Management (RCM) Discover how AI agents are transforming healthcare automation with Navaneeth Nair, exploring their role in improving efficiency, reducing denials, and optimizing revenue cycle management with Chief Product Officer Navaneeth Nair. 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
Discover how AI agents are transforming healthcare automation with Navaneeth Nair, Infinx Chief Product Officer, exploring their role in improving efficiency, reducing denials, and optimizing revenue cycle management. Brought to you by www.infinx.com
In this RCM Insights segment, Stuart Newsome introduces insights from Navaneeth Nair, Chief Product Officer at Infinx, on the critical distinction between automation agents and AI agents in revenue cycle management. Expanding on previous discussions about document automation, this episode explores how proprietary automation platforms drive efficiency, reduce manual workload, and seamlessly integrate with EHR systems, while AI agents play a more advanced role in decision-making and adaptability.
In this episode of Leaders in Medical Billing, host Chanie Gluck welcomes Jonathan LaChapelle, Director of Revenue Cycle Management at Adonis, a cutting-edge revenue intelligence and automation platform designed for healthcare. Jonathan shares insights from his extensive experience in the RCM space and discusses the revolutionary technology-driven capabilities of Adonis that address operational challenges in medical billing. Tune in to discover the innovative solutions that Adonis offers and how they can benefit medical billing companies. Sponsored by 4D Global, empowering medical billing companies through offshore staffing.
AI agents are reshaping healthcare revenue cycle management by automating tasks like eligibility verification, prior authorizations, and denial management. Learn how these tools enhance efficiency, reduce costs, and evolve into an essential part of our everyday lives.
In this episode of Leaders in Medical Billing, host Chanie Gluck interviews Melanie McGivney, Director of Operations at Impact Healthcare Solutions. With over 20 years of experience in revenue cycle management (RCM), Melanie shares insights on operational efficiency, building strong offshore relationships, and overcoming challenges in multi-state hospital billing. From onboarding best practices to the exciting future of AI, this conversation is packed with actionable takeaways for billing professionals aiming to improve processes and client relationships. Sponsored by 4D Global, empowering medical billing companies through offshore staffing.
Curious about how financial priorities can harmonize with a people-centric culture in healthcare? Join us for a compelling conversation with Ken Kaufman, a visionary leader in the dental support organization sector, as he reveals the delicate balance between fostering a thriving organizational culture and achieving financial goals. With his impressive journey from BYU to CFO, Ken offers invaluable insights into strategies for sustainable growth, emphasizing the importance of caring for employees and patients alike. Discover how Ken's passion for startups and the dental industry has shaped his approach to building a culture where financial and cultural priorities are not at odds but work in tandem to drive success.Unlock the secrets of maximizing healthcare revenue as Ken shares his expert advice on creating robust systems and automating processes within practice management. From merging Revenue Cycle Management systems to conducting annual fee schedule reviews, Ken provides actionable steps to optimize collections and streamline operations. Learn how transitioning to accrual accounting and implementing effective analytics can paint an accurate picture of business health while maintaining ethical practices. This episode promises a deep dive into the complexities of financial operations, offering practical guidance to navigate these challenges without losing sight of what truly matters—your organization's cultural core.As we explore the intricacies of compensating healthcare providers and the exciting realm of real estate partnerships, Ken sheds light on incentivizing growth and creating strategic collaborations. Gain insights into salary ranges, compensation structures, and the ever-evolving landscape of commercial real estate ventures. Whether you're a dental practice manager or a healthcare executive, Ken's experience and wisdom will equip you with the knowledge to make informed, strategic decisions that align financial success with a vibrant, people-focused organizational culture.If you need help finding the perfect location or your ready to invest in commercial real estate, email us at admin@leadersre.com Sign up for a FREE vulnerability analysis and lease renewal services View our library on apple podcasts or REUniversity.org. Connect on Facebook. Commercial Real Estate Secrets is ranked in the top 50 podcasts on real estate
Explore how automation can transform revenue cycle processes by eliminating manual inefficiencies, reducing costs, and improving cash flow. Discover targeted solutions that streamline tasks like prior authorization, eligibility verification, and claims management to optimize operational performance.
On today's episode, Mark continues his deep dive with dental billing and revenue cycle management expert Penny Reed, Chief Growth Officer at E-Assist Dental Solutions. Penny breaks down five powerful strategies to improve collections, streamline billing processes, and ensure dental practices get paid what they're owed. From understanding chair hour values and optimizing PPO contracts to collecting patient co-pays upfront and sending clean claims, Penny shares actionable insights for dentists navigating the complexities of insurance and revenue systems. Plus, she highlights the importance of accurate reporting, solid protocols, and leveraging AI tools to simplify communication and billing follow-ups. If you're tired of revenue leaks and denied claims, this episode offers the clarity and tools to transform your practice's financial health. EPISODE RESOURCES https://eassist-dental-billing.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast
On today's episode, Mark welcomes back Penny Reed, Chief Growth Officer at E-Assist Dental Solutions and a leader in dental business coaching. Penny shares her wealth of experience in revenue cycle management (RCM) and explains why a broken billing system can wreak havoc on your cash flow and patient relationships. Together, they dive deep into the importance of accurate insurance verification, airtight financial policies, and clean claims submission to prevent the dreaded "garbage in, garbage out" scenario. Penny also discusses the growing role of AI in claims processing, outsourcing RCM for efficiency, and the critical need for team alignment and communication to ensure a successful partnership. If you've struggled with collections, operational gaps, or billing frustrations, this episode is packed with insights to streamline your revenue systems and boost profitability. EPISODE RESOURCES https://eassist-dental-billing.com https://www.truedentalsuccess.com Dental Success Network Subscribe to The Dentalpreneur Podcast
What the heck is Robotic Process Automation and how does it apply to Revenue Cycle Management? In other words, RPM for RCM. My guest today runs a very successful RCM company that's takes leading the way with new technology very seriously. He'll tell us what all of this means.Vinod (Vinny) brings over 15 years of experience in operations, financial analysis, strategy, growth, corporate development, strategic planning, and marketing. At Medical Billing Wholesalers, he is involved in applying his experience to optimize revenue cycle process flows to improve our clients' profitability and performance.In this episode Carl White and Vinny Sankaran discuss:What RPM is and what it is notGood uses of RPMQuestions to ask your RCM provider about RPMWant to be a guest on PracticeCare®?Have an experience with a business issue you think others will benefit from? Come on PracticeCare® and tell the world! Here's the link where you can get the process started.Connect with Vinny Sankaranhttps://www.linkedin.com/in/vinodsankaran/Connect with Carl WhiteWebsite: http://www.marketvisorygroup.comEmail: whitec@marketvisorygroup.comFacebook: https://www.facebook.com/marketvisorygroupYouTube: https://www.youtube.com/channel/UCD9BLCu_i2ezBj1ktUHVmigLinkedIn: http://www.linkedin.com/in/healthcaremktg
In this episode, David Dawson, senior vice president of Conifer Health Solutions, joins host Dan Karnuta to discuss the use of artificial intelligence in healthcare-related revenue cycle management. They discuss what RCM is, the issues that have caused inefficiencies in the RCM process and how AI is a promising solution for solving them. Karnuta is director of the Professional Program in Healthcare Management at The University of Texas at Dallas Naveen Jindal School of Management.
Marina Bigsby, Chief Customer Experience Officer at AccessOne, focuses on providing financial products and services to help make healthcare more affordable for patients and improve the physicians' revenue cycle management. The aim is to provide more transparency and payment options upfront to avoid situations where patients forgo needed care. Using AccessOne's technology and mobile payment solution, providers collect payments faster and proactively identify and address operational inefficiencies and staffing challenges. Marina explains, "We're a technology company. We partner with our providers and look at their various situations. Their situation might be that they have a pocket of their population with high debt problems, or maybe there is a staff shortage or some other operational efficiency challenge. We're designing a product that works for them. Our platform is highly configurable, and we built something that works for them and helps them collect more so they can allocate funds to wherever they need. We have a proprietary funding option, so they can work with us to accelerate cash quickly into their RCM or manage risk differently. So that's really what we're doing. We're working with them to collect more so they can help more patients." "It's a time savings so that they get cash faster, which is always good, but it's also a time savings from an operational savings. So responses are great -- we send out a text and our MobilePay product is a replacement, a complete replacement of a piece of paper. Awareness of the text helps people say that even if they don't want to pay through the text, they know there's a bill and know it earlier than they normally would have, so they can pay it however they'd like. Whether in a portal or through our text, that awareness is increased. There are lots of glowing reviews around that product." #AccessOne #RevenueCycleManagement #RCM #PatientExperience #PatientFinancing #PatientAccess accessonepay.com Listen to the podcast here
Marina Bigsby, Chief Customer Experience Officer at AccessOne, focuses on providing financial products and services to help make healthcare more affordable for patients and improve the physicians' revenue cycle management. The aim is to provide more transparency and payment options upfront to avoid situations where patients forgo needed care. Using AccessOne's technology and mobile payment solution, providers collect payments faster and proactively identify and address operational inefficiencies and staffing challenges. Marina explains, "We're a technology company. We partner with our providers and look at their various situations. Their situation might be that they have a pocket of their population with high debt problems, or maybe there is a staff shortage or some other operational efficiency challenge. We're designing a product that works for them. Our platform is highly configurable, and we built something that works for them and helps them collect more so they can allocate funds to wherever they need. We have a proprietary funding option, so they can work with us to accelerate cash quickly into their RCM or manage risk differently. So that's really what we're doing. We're working with them to collect more so they can help more patients." "It's a time savings so that they get cash faster, which is always good, but it's also a time savings from an operational savings. So responses are great -- we send out a text and our MobilePay product is a replacement, a complete replacement of a piece of paper. Awareness of the text helps people say that even if they don't want to pay through the text, they know there's a bill and know it earlier than they normally would have, so they can pay it however they'd like. Whether in a portal or through our text, that awareness is increased. There are lots of glowing reviews around that product." #AccessOne #RevenueCycleManagement #RCM #PatientExperience #PatientFinancing #PatientAccess accessonepay.com Download the transcript here
Explore how Artificial Intelligence acts as a symphony within Revenue Cycle Management, with automation, cognitive AI, and generative capabilities each playing a distinct role. Learn how Infinx provides the framework to harmonize these technologies, augmenting human workflows for a seamless and efficient revenue cycle. Brought to you by www.infinx.com
Morgan Stanley Research and Investment Management analysts discuss how AI can keep costs down for the industry and give patients a more personalized experience.----- Transcript -----Craig Hettenbach: Welcome to Thoughts on the Market. I'm Craig Hettenbach, Morgan Stanley's U.S. Healthcare Technology and Providers analyst. Today I'm here with my colleague Steve Rodgers from Morgan Stanley Capital Partners to talk about a growing and underappreciated segment of healthcare – the behind-the-scenes technology that is transforming the sector to keep costs down and improve patient care. It's Monday, December 9th at 9am in New York. In 2022, the size of the U.S. healthcare sector was [$]4.5 trillion and is projected to grow to [$]6.8 trillion in 2030, accounting for 20 per cent of overall U.S. GDP. We know that the U.S. population is aging, and we expect to see 71 million U.S. citizens age 65 and over by 2030. That puts ever growing demand on health care systems. So, Steve, you and your colleagues in investment management have been looking lately at key macro trends driving change in the healthcare sector.What are these drivers and how do they work together?Steve Rodgers: When we look at the health care landscape, we really think about four major macro trends. The first is cost containment. And this is just this simple idea that costs are escalating at an unsustainable rate. The second is demographics; we also know that things like obesity is increasing the prevalence of chronic conditions and increasing the overall utilization of the healthcare system. And so, we're looking at ways to invest behind that macro trend. We've also identified something called consumerism. And consumerism stems from the reality that today, patients are taking more of a financial responsibility in their healthcare. And with that comes more decision making. So, the old days – where the patient received healthcare services, but the payer paid, and there was really no link between the two – have moved on.We call it the retailization of health care. Waiting in the office for your appointment for 30 minutes used to be a standard. Today, that's unacceptable because these patients will move to the next provider who's providing them a better retail experience. The final macro driver we call enabling technology. Health care has lagged many other industry segments in the use of technology as a source of efficiency. I like to give the example of chemotherapy treatments, right? Technology would produce a new chemotherapy treatment, and while that's great for patient care and outcomes. It actually could lead to increased costs to the system because it was an added route that people would go down.Now there's technology which allows a provider to say, “Start with this one because of your genetic makeup.” And not only will you have a better outcome more quickly, but it will be less cost to the system. We're also seeing that kind of efficiency happen on the administrative side of healthcare as well. The way we think about these macro trends and how they work together is really thinking about demand versus supply. So, we see demand drivers coming from demographics and consumerism. We see supply drivers coming from cost containment and really enabling technology has impacts on both demand and supply.Craig Hettenbach: Let's focus more specifically on just how digitization and cost containment dovetail. When people talk about the impact of AI and ML on healthcare, typically the focus is on things like big pharma, medical equipment, and hospitals. But there's actually a whole intricate infrastructure that helps healthcare run.Can you talk about these behind-the-scenes businesses and why investment managers are so interested in the opportunities they offer? Steve Rodgers: Yeah, it's really important. We focus on investments that are using technology to enable their businesses. And so that's automation. That's machine learning. It's AI. But all of these technologies are being used behind the scenes to make care more efficient and they're a better use of our dollars. For example the personalization of communications from health plans. So historically a health plan would send the same communication, you know, to – the same form to every patient.Well now, technology allows the health plan, at the point of generating that communication, to know that information about the person that's getting it. And having the ability to personalize it in ways that might help them be more likely to interact with it. Maybe they're trying to get them to do something about their health. Well, they can take an administrative communication, you know, called an explanation of benefit, which really just explains how much you owe versus how much the health plan owes. And you can also add important information to that that might help you utilize your benefits better.Another example that we see is on the hospital side. As people I think have heard, hospitals have been very inefficient, right? They pay bills the wrong bills, they're duplicative invoices, and there haven't been really good ways to figure that out. Well, we now have technology that can identify those duplicative invoices, that can actually identify that there are multiple contracts that they have with a vendor and direct them to use the cheapest one.Last one that I would highlight is around the procurement of pharmaceuticals. So, again, if you imagine a hospital system that has 50 different hospitals and one person at each hospital might be buying the pharmaceuticals that fit to the needs they have in that facility. Well, now there's technology that's really helping consolidate those purchases, get the benefits of scale. Also tracking what is a very dynamic pricing market and figuring out today this channels is less costly than that one, so buy it from here; tomorrow it might be different.We're seeing behind-the-scenes uses of technology in all of those types of areas, which are leading to efficiencies. Craig Hettenbach: That's really interesting and I agree. Sometimes investors can overlook healthcare infrastructure as an area offering a lot of hidden growth. Let's take a subsector like Revenue Cycle Management or RCM. What is it exactly and what opportunities does it offer when it comes to technology and cost containment?Steve Rodgers: What it is, it really is the whole process from start to finish of a healthcare episode. So, starting with something as simple as eligibility, or is this patient eligible for this procedure?Then once that procedure happens, it has to be documented and coded and billed. And then once that bill goes out that needs to be collected and paid on. So, this whole process is really how healthcare works and it's one of the most important business processes for healthcare companies .And what we've seen with revenue cycle is it's been a very, historically, a very manual process that involved a lot of human effort. So early on, some of the most basic functions of revenue cycle were automated. So, the example I can give there would be the front-end entry of a claim.So that used to be sent over by fax and a person would have to look at that and type it into a computer and start the processing that way. Well that, for a long time, that's now been automated with either what's called OCR, which is a scanning technology. But even, you know, now, a lot of that's coming in digitally. But a lot of the rest of the process is still manual. And the reason is because the tasks are so complex. So, to resolve a claim, you often need to pull data from multiple sources. There'd be some subjective determinations about what's allowed or not allowed.You would then need to apply [it] against a multiple complex rules and benefits. And sometimes the sheer dollars involved would make it too risky to just pay that claim without someone actually looking at it. Really we're entering an automation cycle where some of these new technologies are making it possible to reliably automate these more complex functions.And so it's a combination of machine learning and AI but it's really driving efficiencies that are really exciting from an investment perspective to us right now.Craig Hettenbach: Got it. In addition to revenue cycle management, are there any other subsectors that look interesting to you right now?Steve Rodgers: We also, we call it cost cycle management. This is the idea of applying the same principles that we're seeing in revenue cycle to the purchasing of providers. So that can be supply costs, inventory management. Another area that we think is interesting is self insured employer outsourcing. One of the main frustrations that we hear time and time again from self insured employers is that their employees are not utilizing the benefits that they have. With technology, companies that are finding ways to get broader and better adoption; then in turn allowing these employers to see better utilization, which is going to lead to a healthier workforce and hopefully do so also, with some cost containment.So Craig, it's clear that there's an overlap between what we look at from the investment management side and what you and your colleagues focus on in research. How do you think about analyzing how AI and machine learning are impacting healthcare?Craig Hettenbach: Yeah, so for research across the department, we came up with a framework to look at and that's the NEXT framework. So number one, new business opportunities to evaluate. Number two, efficiencies. Number three, external productivity. And number four, content creation. So those are four things to help kind of frame what the opportunity set looks like, when leveraging AI and technology.Steve Rodgers: And how does this framework apply to your space, healthcare services and technology specifically?Craig Hettenbach: The second point of that next framework, the E for efficiencies, is something that we're already starting to see the tangible benefits. And so, just to give you some context here, the CEO of a leading hospital, at a conference recently said that 25 to 30 per cent of overall healthcare costs are tied to administrative.So there is a lot of low hanging fruit there. There's other areas within whether you think about things like prior authorizations that are still done manually, either via fax, phone, email. Those are things that some health plans and technology partners are looking to automate. So, I think the efficiencies – we're still early on, but you're starting to see at least the business case in terms of investments there.And then there's the longer term look on the clinical side. And I think the understanding there is that's going to take longer. An executive at a recent industry conference I was at, I thought he said it best when he said, ‘You know, AI is going to save time before it saves lives.' Steve Rodgers: How is this technology changing how physicians or providers do their jobs?Craig Hettenbach: When we look at what's happened with physicians and nurses and still not too far removed from COVID and just burnout, it's palpable. And I think it's something that technology can certainly be used as an enhancer.So ambient listening is a new technology. When we think about electronic health records; yes, it's great to get that information into that record, but it's also timely and consuming. And so, I think things like that – that can listen to and populate notes – is going to be a real time saver for both doctors and patients.And on the patient side as well, when we think about just our experience, right? Healthcare just has a long ways to go in terms of response time. And that's something that I think more automation and technology, whether it's things like scheduling or check-ins and things like that, I think ultimately you'll see more technology deployed.Okay, Steve, are there any other potentially overlooked near term or longer-term pockets of opportunity within health care that you think investors should focus on?Steve Rodgers: Yeah, I think a general rule for investors or, you know, a heuristic that they should think about is, really trying to invest behind the things that are providing – really trying to stay on the right side of healthcare. And so, when we look at things like cost containment, you know, we see companies out there where they might be benefiting from inefficiency in the system. Those are things that I'd stay away from. I'd focus on companies that are providing better quality care at a lower cost and staying on the right side of healthcare. Because I do believe that a lot of these investments – the AI, the technology – are going to drive efficiency and really eradicate some of these business models that are really taking advantage of the inefficiencies in the healthcare system.Craig Hettenbach: Great, Steve, well that's very helpful and thanks for taking the time to talk today.Steve Rodgers: Great speaking with you, Craig.Craig Hettenbach: And thanks for listening. If you enjoy Thoughts on the Market, please leave us a review wherever you listen and share the podcast with a friend or colleagues today.
James Grover, President of Vyne Dental, addresses the friction and inefficiencies in the dental healthcare system to facilitate payments and improve patient outcomes. The dental care environment is fragmented and lacks coordination between patients, dentists, and payers. Vyne Dental works with dental practices to streamline the revenue cycle management process, improve patient communication, and ensure timely and accurate payments. James explains, "We sit at the commerce crossroads between patients, practices, and payers, basically helping patients to pay, helping payers to pay, and helping practices to get paid for the services that they're rendering." "Then in the payer space, they're trying to avoid fraud. They also have certain places where there are plans that approve certain things but don't allow for others, and they need to do their work. Unfortunately, there's a tremendous amount of waste between all three constituents. That waste results in higher prices for patients and less business success for both practices and payers." "So you have a patient who gets services and the practice is pretty much programmed to get that payment when the patient comes back in the next time. Why? Because they want their insurance to pay for it. For practices to get paid, that patient has to come back in. Well, there's a huge problem. The ADA says that only about 41% of new patient visits result in the patient returning. And so, about six in ten new patients don't return to the practice, and there is only about 85% retention of existing patients." #VyneDental #AccelerateRev #DentalBilling #RCM vynedental.com Listen to the podcast here
James Grover, President of Vyne Dental, addresses the friction and inefficiencies in the dental healthcare system to facilitate payments and improve patient outcomes. The dental care environment is fragmented and lacks coordination between patients, dentists, and payers. Vyne Dental works with dental practices to streamline the revenue cycle management process, improve patient communication, and ensure timely and accurate payments. James explains, "We sit at the commerce crossroads between patients, practices, and payers, basically helping patients to pay, helping payers to pay, and helping practices to get paid for the services that they're rendering." "Then in the payer space, they're trying to avoid fraud. They also have certain places where there are plans that approve certain things but don't allow for others, and they need to do their work. Unfortunately, there's a tremendous amount of waste between all three constituents. That waste results in higher prices for patients and less business success for both practices and payers." "So you have a patient who gets services and the practice is pretty much programmed to get that payment when the patient comes back in the next time. Why? Because they want their insurance to pay for it. For practices to get paid, that patient has to come back in. Well, there's a huge problem. The ADA says that only about 41% of new patient visits result in the patient returning. And so, about six in ten new patients don't return to the practice, and there is only about 85% retention of existing patients." #VyneDental #AccelerateRev #DentalBilling #RCM vynedental.com Download the transcript here
In this episode, recorded live at the Becker's Healthcare 12th Annual CEO + CFO Roundtable, Michael Palmer, Vice President and Deputy Chief Information Security Officer at R1RCM, dives into the critical role of cybersecurity within healthcare revenue cycle management. Palmer discusses key challenges, from handling interconnected healthcare systems to safeguarding against ransomware and denial of service attacks, and emphasizes the importance of vendor security protocols and continuous monitoring to mitigate evolving cyber threats.
We are happy to welcome Colleen Huff to the Growth in Dentistry podcast! Colleen is a Revenue Cycle Management expert with 30 years of dental industry experience. Listen in to hear Colleen and Steve discuss:Revenue Cycle Management challenges in dentistry, particularly after the Change Healthcare breach and how AR days are up since the breachImportance of understanding clearinghouse operations and insurance claim processesTips for managing claims and time management strategies…and so much more!Check out Colleen's book, *A Mouthful of Insurance*, out now: https://www.amazon.com/Mouthful-Insurance-Proper-training-tomorrow/dp/B0D8WLNZ3T. See a demo of DI and get a $50 gift card: http://get.dentalintel.net/podcast.
November 1, 2024 Ray and Scott talk PRS MS Director of Operation, Marianne Desciose about Revenue Cycle Management (RCM) current and sometimes hidden issues.PRS Billing and Other Services - Book a Call with Mark Painter or Marianne DescioseClick Here to Get More Information and Request a QuoteUrology Advanced Coding and Reimbursement Seminars - In-Person SeminarsRegister Now for the Urology Advanced Coding and Reimbursement SeminarClick Here for Information and RegistrationEvent DetailsLocation:Las Vegas: December 6-7, 2024, at HorseshoeNew Orleans: January 31-February 1, 2025, at Harrah'sTime: Friday 8 am - 4 pm, Saturday 8 am - 3:30 pmIncludes: Breakfast and Lunch on both days, plus 14 AAPC CEUs The Thriving Urology Practice Facebook group.The Thriving Urology Practice Facebook Group link to join:https://www.facebook.com/groups/ThrivingPractice/ Click Here to Start Your Free Trial of AUACodingToday.com
In this episode, Kathy LeBrew, Executive Vice President, Chief Transformation Officer, and Chief Revenue Officer at M Health Fairview, discusses the evolving healthcare landscape. Kathy shares insights on the impact of caregiver burnout, the rise of cybersecurity threats, and how M Health Fairview is navigating managed care and financial performance. She also reflects on leadership's role in healthcare's future, emphasizing people and innovation.
This episode of the Becker's Healthcare Podcast tackles the financial realities of dentistry with Cissy Mangrum and Marci Sweet. Cissy, Senior Vice President of Revenue Cycle Management at Specialty Dental Brands, and Marci, Vice President of Marketing at DentalXChange, discuss the challenges DSOs and practices face, and how automation in RCM is revolutionizing the financial landscape.This episode is sponsored by DentalXChange.
Gretchen Case, Managing Partner at The Wilshire Group a boutique healthcare revenue cycle consulting company that helps healthcare clients streamline workflows and processes. They work with hospitals, physician groups, and other providers to optimize their investment in technology and improve patient outcomes. Gretchen points out the various aspects of revenue cycle management, which include insurance benefit verification, explanation of costs, and identification of financial support. The middle revenue cycle includes the codification of clinical data and coordination with insurance companies and electronic health records. The third phase is the billing and payment. Gretchen elaborates, "Some of the automation I've seen over the last several years has been designed to query the documentation and come up with suggested codes, called computer-assisted coding. And there is a lot of that in play. I think it expedites things and it makes things more efficient. I don't know of anybody who's just flipped that button and left it behind and not continued to monitor and manage it." "There's also movement right now around what we call a single path. That's just one way of saying it, but it's about coding the professional and the technical at the same time. What does that mean? The physician's procedure charge and the technical is what the hospital is going for that technical component of the services. And a lot of times, we share codes. So, if you're going to be coding the physicians and getting her bill out the door correctly, you might as well be coding the hospital one at the same time. So there are definitely developments there, but I haven't seen anything. Just completely automate it and step away." #TheWilshireGroup #RevenueCycleManagment #RCM #Hospitals thewilshiregroup.net Listen to the podcast here
Gretchen Case, Managing Partner at The Wilshire Group a boutique healthcare revenue cycle consulting company that helps healthcare clients streamline workflows and processes. They work with hospitals, physician groups, and other providers to optimize their investment in technology and improve patient outcomes. Gretchen points out the various aspects of revenue cycle management, which include insurance benefit verification, explanation of costs, and identification of financial support. The middle revenue cycle includes the codification of clinical data and coordination with insurance companies and electronic health records. The third phase is the billing and payment. Gretchen elaborates, "Some of the automation I've seen over the last several years has been designed to query the documentation and come up with suggested codes, called computer-assisted coding. And there is a lot of that in play. I think it expedites things and it makes things more efficient. I don't know of anybody who's just flipped that button and left it behind and not continued to monitor and manage it." "There's also movement right now around what we call a single path. That's just one way of saying it, but it's about coding the professional and the technical at the same time. What does that mean? The physician's procedure charge and the technical is what the hospital is going for that technical component of the services. And a lot of times, we share codes. So, if you're going to be coding the physicians and getting her bill out the door correctly, you might as well be coding the hospital one at the same time. So there are definitely developments there, but I haven't seen anything. Just completely automate it and step away." #TheWilshireGroup #RevenueCycleManagment #RCM #Hospitals thewilshiregroup.net Download the transcript here
You may remember that last year we shared a video interview with FinThrive talking about a new RCM technology adoption model that they had put together and were sharing with the industry at HFMA. At this year's HFMA, I wanted to follow up with the FinThrive team to learn about what's happened with the adoption model since they first launched it and what's changed. In order to really understand the evolution and use of the adoption model, we were excited to sit down for an interview with Jeff Becker, Vice President of Portfolio Marketing at FinThrive, Mike Vigo, Chief Revenue Officer at UC San Diego Health, and Kim Waters, Principal, Advisory Services at CereCore. This was a great opportunity to hear from a healthcare organization that had used the Revenue Cycle Management Technology Adoption Model (RCMTAM as it's now often called) and also the recent announcement of CereCore working with FinThrive to leverage the RCMTAM with the CereCore clients. Learn more about CereCore: https://cerecore.net/ Learn more about UC San Diego Health: https://health.ucsd.edu/ Learn more about FinThrive: https://finthrive.com/ Health IT Community: https://www.healthcareittoday.com/
Send us a Text Message.Both patients and providers are more than familiar with the headaches associated with collecting payments.But what solutions are there that support both patients and providers?In this episode of HealthBiz Briefs, Tom Furr, CEO of PatientPay reveals how things like the Affordable Care Act are driving out-of-pocket costs and what the solutions are for supporting providers in collections without damaging patient opinions in the process.This episode is brought to you by BetterHelp. Give online therapy a try at https://betterhelp.com/caretalk and get on your way to being your best self.As a BetterHelp affiliate, we may receive compensation from BetterHelp if you purchase products or services through the links provided.
In this episode of Leaders in Medical Billing, Chanie Gluck interviews Ashish Mandavia, a trained physician and now CEO and co-founder of Sohar Health. Ashish shares his journey from practicing psychiatry to becoming a healthcare tech entrepreneur, discussing the motivations behind his career shift and the challenges he faced in the process. He explores systemic issues in healthcare that motivated him to innovate, particularly focusing on revenue cycle management (RCM) and the need for better technology in this space. The conversation also delves into differences in healthcare systems between the U.S. and Europe, the impact of AI on healthcare, and the future of preventative care. Timestamps: 00:00 - 02:00 - Introduction by Chanie Gluck, overview of the podcast. 02:01 - 05:00 - Introduction of guest Ashish Mandavia and his background. 05:01 - 10:00 - Ashish's journey from practicing psychiatry to entering healthcare tech. 10:01 - 15:00 - Challenges in the U.S. healthcare system and Ashish's motivation to innovate. 15:01 - 20:00 - Discussion on revenue cycle management (RCM) and why physicians avoid taking insurance patients. 20:01 - 25:00 - Overview of Sohar Health's solutions for automating RCM processes. 25:01 - 30:00 - Importance of accuracy in RCM and the role of AI in improving healthcare processes. 30:01 - 35:00 - Future of Sohar Health and broader healthcare industry trends. 35:01 - 40:00 - Ashish's perspective on AI and preventative care in healthcare. 40:01 - 45:00 - Closing thoughts, upcoming conferences, and where to find Sohar Health.
This episode of the Becker's Healthcare Podcast tackles the financial realities of dentistry with Cissy Mangrum and Marci Sweet. Cissy, Senior Vice President of Revenue Cycle Management at Specialty Dental Brands, and Marci, Vice President of Marketing at DentalXChange, discuss the challenges DSOs and practices face, and how automation in RCM is revolutionizing the financial landscape.This episode is sponsored by DentalXChange.
The integration of artificial intelligence (AI) into healthcare revenue cycle management is becoming increasingly vital as organizations strive to optimize efficiency, reduce costs, and improve patient outcomes. As AI application in healthcare revenue gains traction, it's crucial to distinguish between genuine AI innovations and surface-level automation. The right technology can significantly impact revenue cycle efficiency and compliance.But how can healthcare organizations discern between genuine AI solutions and those simply leveraging automation?In this special episode of Highway to Health, Nick Tombrella, Senior Vice President of Sales at Waterlabs AI, hosts an enlightening discussion with Kamal Raj, CEO and Founder of Waterlabs AI, and Lauralea Tanner, an Advisory Board Member at the company. Together, they explore the critical role of AI in healthcare revenue cycle management, the challenges of automation, and how Waterlabs AI stands out in the competitive landscape.Key discussion points include:- The distinction between true AI and Robotic Process Automation (RPA) in healthcare applications.- The areas of revenue cycle management most in need of AI-driven automation, such as accounts receivable and coding.- Compliance concerns in integrating AI into healthcare systems and how Waterlabs AI addresses these challenges.Lauralea Tanner is an accomplished executive with extensive experience in healthcare revenue cycle management, sales, and business transformation. Currently serving as an Advisory Board Member at Waterlabs AI, she also leads CHT Holdings LLC as CEO and is a former Chief Growth Officer at Acclara. Throughout her career, she has consistently driven top-line revenue growth, improved operational efficiency, and led successful mergers and acquisitions.Kamal Raj is the founder, President, and CEO of Waterlabs AI, where he leads the development of conversational user interfaces (CUI) for healthcare revenue cycle management. With over 25 years of IT industry experience, he has a strong track record in aligning IT and business strategies, optimizing operational efficiency, and driving value creation. Prior to Waterlabs AI, he was the Associate Vice President at Omega Healthcare, where he played a key role in building the global enterprise tech network for over 25,000 employees.
Learn how Rick Tully, Executive Director of Revenue Cycle Management, navigated the complexities of a cyberattack sharing valuable insights and strategies for enhancing cybersecurity. Discover strategies for enhancing cybersecurity, including the use of dual clearinghouses, and the balance between manual processes and automation to ensure operational continuity. Brought to you by www.infinx.com. 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/
Learn how Rick Tully, Infinx Executive Director of Revenue Cycle Management, navigated the complexities of a cyberattack and sharing valuable insights and strategies for enhancing cybersecurity. Discover strategies for enhancing cybersecurity, including the use of dual clearinghouses, and the balance between manual processes and automation to ensure operational continuity. Brought to you by www.infinx.com
Our special guest this week is Sarah Armstrong, CEO of Trend Health Partners and my good friend from over the years. Sarah has always shown me kindness and postivity. Being in the business of people is built into her and with this episode we found out some of the "why". Sarah opened up to us and walked us through her incredible journey. Like any journey it's full of amazing highs and really low lows. Through it all Sarah persevered and even changed Ben's mind on payor relationships. It's a must listen podcast for this season. Remember to like and subscribe! Chapters 03:01 Payment Integrity and Communication Challenges 07:14 Making Small Changes in Healthcare 10:39 The Attitude Towards Fixing Healthcare 23:28 Personal Loss and Suffering 31:19 The Power of Empathy and Support 36:10 Embracing the Good and the Bad in Life 43:22 Leadership through Individual Connections 46:05 Showing Up for Others 48:11 Embracing Work-Life Fluidity and Authenticity 50:08 The Constant Pursuit of Improvement as a CEO 55:24 Engaging in Conversations about Healthcare and Revenue Cycle Management
Whether you are an agency owner looking to enhance your financial operations or an administrator curious about how your team can better manage the fiscal realities of the home care sector, this episode is a masterclass in navigating the shifting landscapes of health care finance. Learn about navigating the complexities of Medicaid disenrollments and electronic visit verification (EVV) as Alik Kassner, co-managing partner of Alpine Homecare, provides insight into improving revenue cycle management (RCM) practices. With Alik's impressive banking and health care background, he discusses formidable obstacles, the essential role of forecasting, and how state assistance and advanced technology merge to create a robust RCM system. If you liked this episode and want to learn more about all things home-based care, you can explore all our episodes at alayacare.com/homehealth360.
Join us in our latest episode as we introduce a groundbreaking partnership with MedLink Management, featuring Meghan, an expert in the field of ABA billing. Starting her career as a Registered Behavior Technician and advancing to obtain a master's in Organizational Behavior Management from Benedictine University, Meghan has seamlessly transitioned into the realm of ABA administration. Her extensive experience and unique insights into insurance compliance and revenue cycle management have shaped her mission to optimize billing processes for ABA practices.In this episode, we announce a comprehensive ABA Billing Training Series, meticulously designed for ABA providers eager to gain a profound understanding of the billing process and master the nuances of ABA therapy billing. This series is tailored to equip you with the knowledge and skills needed to efficiently manage your billing system, ensure compliance, and optimize your reimbursement rates.Exclusive Resources:Enroll in the Full Course: Ready to take control of your billing process? Enroll in our comprehensive Revenue Cycle Management course here: https://3piesquared.com/productDetails/Revenue_Cycle_ManagementFree ABA Billing Tips: Boost your billing knowledge with our free ABA Billing Tips. Download your guide here: https://3piesquared.com/productDetails/ABA_Billing_TipsThis training series is ideal for ABA providers looking to take charge of their billing processes in-house or refine their existing operations to ensure maximum efficiency and compliance. Don't miss this opportunity to elevate your ABA practice's billing capabilities!
In this episode we are joined by Laxmi Patel, Chief Strategy Officer at Savista, and Kaleigh Stetler, Head of RCM at Asante Health System, as they discuss how Asante has transformed its RCM approach. Learn how they selected an RCM partner, the impressive results they achieved, and valuable tips for healthcare leaders considering outsourcing RCM.This episode is sponsored by Savista.
We're exploring a billion-dollar industry that's basically hidden within the healthcare field called Revenue Cycle Management.Our guest, Lance Gainer, is my cousin and a seasoned consultant in revenue cycle management within the healthcare industry, with a strong background in leadership and growth. His journey started at Labcorp, where he ascended through the corporate hierarchy. Gainer perceives revenue cycle management in healthcare as a lucrative niche filled with opportunities for growth and advancement. Learn more about our guest's business here: https://resilientrevenue.comFOLLOW BOSSLOCKS MEDIA- Text us +1(914)-353-4176- Learn more about our guest: www.bosslocksmedia.com/- Join the I Love New Growth Newsletter: https://norby.link/c5YDwu- Follow us on your favorite social platforms: https://bosslocks.norby.live- YouTube: https://www.youtube.com/@bosslocksmedia(00:00:34) Healthcare Revenue Management: Navigating Financial Impacts(00:03:49) Adapting Career Trajectory Through Unexpected Turns(00:06:36) Mastering Revenue Cycle Management in Healthcare Operations(00:18:18) Healthcare Finance Impact on Revenue Stability(00:32:08) Networking Success: Optum Consulting Role Achievement(00:40:01) Hospital Revenue Management Business Success Story(00:43:47) Maximizing Efficiency Through Overseas Revenue Management Outsourcing(00:46:30) Enhancing Revenue Cycle Management with Diverse Platforms
Achieving high-performing revenue cycle management (RCM) begins with understanding where your healthcare organization falls on the RCM Maturity Framework, according to Matt Bridge, senior vice president for AGS Health.Bridge, who will be the special guest during the next upcoming edition of Talk Ten Tuesdays, says this four-stage framework informs a strategic roadmap designed for optimizing and digitally transforming revenue cycle performance and future proofing operations through a hybrid model of in-house management, globalized services, advanced technologies, and actionable analytics. Bridge will begin the first installment in his three-part series on the contemporary challenges facing revenue cycle management personnel during the popular weekly Internet radio broadcast.The broadcast will also feature these other instantly recognizable segments:• Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.• Social Determinants of Health: Tiffany Ferguson, CEO for Phoenix Medical Management, Inc., will report on the news happening at the intersection of medical record auditing and the social determinants of health (SDoH).• News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.• TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.
Cracking the code on healthcare revenue? Join Becker's Healthcare and Deepali Shah, SVP of Revenue Cycle Management at Conifer Health Solutions, as they dissect the biggest challenges in RCM today. From process bottlenecks to strategic solutions, this episode is your one-stop shop for optimizing your revenue cycle and boosting the bottom line.This episode is sponsored by Conifer Health Solutions.
Jon Hook, CFA, Senior Analyst at Voss Capital, joins the podcast to discuss his thesis on R1 RCM Inc. (NASDAQ: RCM), a leading provider of technology-driven solutions that transform the patient experience and financial performance of healthcare providers. For more information about Voss Capital, please visit: https://www.vosscap.com/ Chapters: [0:00] Introduction + Episode sponsor: Alphasense [1:30] What is $RCM and why are they interesting to Jon Hook [3:47] Why tax is 4-6% (vs. 2% or 20%) [6:20] Jon Hook's background [8:50] $RCM elevator pitch [15:43] $RCM going concerns: addressing short reports, challenging 2022, management change [22:36] Sutter roll-out [27:37] Network effects / competitive landscape [32:32] Addressing add-backs, adjusted EBITDA [37:10] Addressing stickiness of the business [40:53] Providence acquisition and capital allocation strategy [48:22] Final thoughts on $RCM short report [52:11] Coder shortage [54:31] Optum ($RCM largest competitor) [58:33] $RCM final thoughts Today's episode is sponsored by: Alphasense This episode is brought to you by AlphaSense, the AI platform behind the world's biggest investment decisions. The right financial intelligence platform can make or break your quarter. AlphaSense is the #1 rated financial research solution by G2. With AI search technology and a library of premium content, you can stay ahead of key macroeconomic trends and accelerate your investment research efforts. AI capabilities, like Smart Synonyms and Sentiment Analysis, provide even deeper industry and company analysis. AlphaSense gives you the tools you need to provide better analysis for you and your clients. As a Yet Another Value Podcast listener, visit alpha-sense.com/fs today to beat FOMO and move faster than the market.