Claims Theory

Lindsay Gross
  • 5.0 (3)
  • BUSINESS

Claims Theory is a revenue cycle management consulting firm that specializes in audits, process improvement, staffing and so much more. Our episodes will feature topics and guests related to revenue cycle management, healthcare and medical billing.

Episodes

  1. SEP 11 · VIDEO

    Audits, Investigations, and the Revenue Cycle: A Compliance Insider's View

    In this episode of the Claims Theory Podcast, Lindsay Gross sits down with Sean Weiss- better know as The Compliance Guy- to unpack the most common compliance issues that trigger audits, investigations, and even litigation. From documentation pitfalls and coding errors to government enforcement trends from OIG, DOJ, and CMS, Sean shares real-world insights and practical steps providers can take to stay audit-ready. Whether you're a healthcare exectuive, revenue cycle leader, or compliance professional, this episode will give you a clear view into how compliance protects both revenue and reputation.

    34 min

  2. AUG 19 · VIDEO

    From Psychiatry to Insurance Verification: How Dr. Ashish Mandavia Is Rewiring the Front End of Revenue Cycle

    From psychiatry to revenue cycle tech- Dr. Ashish Mandavia's journey is anything but traditional. In this episode, Lindsay Gross talks with the founder and CEO of Sohar Health about his path from practicing psychiatry in the UK to building two healthcare technology companies, including his latest venture focused on automating insurance verification and fron-end RCM workflows. Together they explore why the front end of revenue cycle is still such a stubborn bottleneck, what "smart automation" really looks like, and how clinical insight shapes better tech.

    28 min

  3. JUL 14 · VIDEO

    Building and Scaling High-Performing RCM Teams with Kari Sewell

    In this episode, Lindsay Gross sits down with Kari Sewell, Vice President of Revenue Cycle at Optum, to explore what it really takes to build and scale high-performing revenue cycle teams. From hiring and onboarding to leadership strategies and team culture, Kari shares her perspective on how to create teams that not only meet metrics, but exceed expectations. Whether you're leading and RCM department or building one from the ground up, this conversation offers valuable insight and practial takeaways.

    26 min

  4. JUN 27 · VIDEO

    Building a Data-Driven Culture in Healthcare with Carly Wagner

    In this episode of Claims Theory, Lindsay Gross sits down with Clinical Data Scientist Carly Wagner to explore what it really means to be data-driven in healthcare. From building a culture of data literacy to dealing with messy, inconsistent data sources, Carly shares her perspective on what it takes to turn analytics into action. They dive into the importance of leadership, clean data, cross-functional alignment, and the practical steps healthcare organizations can take to move from static reports to meanigful decisions. A must-listen for any leader navigating healthcare operations, RCM, or clinical data strategy.

    22 min

  5. MAY 30 · VIDEO

    Building a Scalable Training Platform for a Growing Organization

    In this episode, Lindsay Gross sits down with Adena Dorsey, Director of Change and Organizational Development at Intellivo, to talk about what it really takes to build a scalable training platform as your organization grows. From starting with the right foundation to avoiding the pitfalls that cause training to break down, Adena shares practical strategies that every healthcare leader should hear. Whether you're building from scratch or refining what you already have, this episode is packed with insight.

    25 min

  6. APR 10 · VIDEO

    The Power of Smart Networks in Revenue Cycle: A Conversation with Lisa Rock

    In this episode of the Claims Theory podcast, Lindsay Gross sits down with Lisa Rock, President of Unity Preferred Network, to explore how smart provider networks are reshaping the revenue cycle. From fair pricing and direction of care to out-of-network strategies, rural providers, and de novo surgery centers, Lisa shares how Unity is building a more equitable and efficient ecosystem for both providers and patients. If you're looking to strengthen your reimbusrment strategy or better understand the future of care delivery, this conversation is packed with insights you won't want to miss.

    15 min

  7. MAR 11 · VIDEO

    Navigating Challenges in Healthcare RCM with Mark Dorner | Mar 11, 2025 003

    In this episode of the Claims Theory Podcast, I sit down with Mark Dorner, CEO of PreciseMDX, to explore the biggest challenges facing healthcare revenue cycle management (RCM) today. We discuss common inefficiencies, the evolving role of technology and automation, and how AI is reshaping the future of revenue cycle operations. Mark shares insights from his experience building RCM systems, highlighting where providers struggle the most and how innovative solutions can drive better finanical and operational outcomes. Whether you're a healthcare leader, RCM professional, or tech enthusiast, this conversation offers valuable takeaways on navigating the complexities of modern RCM. Tune in now!

    31 min

  8. FEB 24 · VIDEO

    The Next Generation of RCM: Attracting Young Talent with Lexi Miller

    In this episode of the Claims Theory Podcast, I sit down with Lexi Miller, a business and marketing major at Purdue University, to explore how the next generation views work, technology, and career opportunities- especially in revenue cycle management. We discuss what attracts young professionals to an industry, the role of technology in shaping their expectations, and how RCM leaders can adapt to engage and retain the workforce of the future. Don't miss this fresh perspective on the evolving job market and what it means for the future of healthcare revenue cycle!

    20 min

  9. FEB 3 · VIDEO

    The Future of RCM: How AI is Transforming Workflows Jan 31, 2025 001

    In this episode, I sit down with Ian Barkin to explore how AI is revolutionizing workflows across industries. We discuss how businesses are leveraging AI to automate tasks, improve efficiency, and unlock new opportunities. Tune in for insights, real-world examples, and practical takeaways on integrating AI into your workflows!

    35 min
  • 9 Episodes

Ratings & Reviews

5
out of 5
3 Ratings

About

Claims Theory is a revenue cycle management consulting firm that specializes in audits, process improvement, staffing and so much more. Our episodes will feature topics and guests related to revenue cycle management, healthcare and medical billing.

Information

  • Creator
    Lindsay Gross
  • Years Active
    2K
  • Episodes
    9
  • Rating
    Clean
  • Copyright
    © 2025
  • Show Website
    Claims Theory