For The Love of Revenue Cycle

Vanessa Moldovan
  • 5.0 (25)
  • Medicine
  • Updated Weekly

Did you ever wish that you had a physician revenue cycle expert and mentor with over 20 years of experience whispering success secrets in your ear? That's exactly what you will get when you tune into For the Love of Revenue Cycle hosted by me, Vanessa Moldovan. My career and my life have brought me a wealth of knowledge and I can't wait to share with you. My passion is to help others in the industry to reach their full potential and find success in the wonderful, crazy world of physician revenue cycle. Whether you are a beginner, expert, physician, consultant, educator or just plain curious, each episode is designed to immediately apply to your career, business and operations. Join me each week as we tackle the topics, trivia and triumphs of revenue cycle. Let's discover our full potential together.

  1. May 19

    FTLORC Live Denials Q&A! 05/12/26

    In this FTLORC Live Denial Q&A, Vanessa Moldovan shares takeaways from APC's HealthCon in Dallas. The episode focuses on denial/non-payment escalation beyond traditional corrected claims and appeals, tracking trends, using payer policy language in second appeals, and briefly contrasts out-of-network strategies (ERISA, patient/employer involvement, No Surprises Act). 00:00 Welcome and HealthCon Takeaways 00:47 Why Prior Auth Hurts Most 03:45 Traditional Appeals No Longer Enough 08:01 Escalation Step One Contract Review 10:37 Escalation Step Two Payer Relations 13:24 Escalation Step Three Insurance Commission 15:02 Grievances and Legal Options 19:00 Q&A Prior Auth Second Appeal Tips 24:41 Q&A When to Escalate and Trend Tracking 30:34 Wrap Up Community and Out of Network

    35 min

  2. May 12

    Ep. 51 - RCM Leadership in FQHCs with Kara Onorato and Jason Lafayette

    Vanessa Moldovan hosts a first-time dual interview on revenue cycle leadership in federally qualified health centers (FQHCs) with Kara Onorato, CFO, and Jason Lafayette, Director of Revenue Cycle at MCR Health. They discuss MCR's scope (over 27 sites, three mobile units, extensive specialties, clinical trials, and 14 in-house pharmacies) and the FQHC mission to provide care regardless of ability to pay. They highlight trust, transparency, and data-driven partnership, and close with practical takeaways: stay vigilant, analyze denials and yields, educate teams, and lead adaptively. 00:00 Welcome 01:31 Meet the Guests 03:07 Kara CFO Journey 05:34 Jason Revenue Cycle Path 10:25 What Is MCR Health 11:54 Understanding FQHC Patients 15:52 Finding Community Health Centers 17:09 CFO Challenges in FQHCs 19:29 FQHC Revenue Cycle Differences 22:39 Preventing Revenue Leakage 25:32 CFO and Rev Cycle Partnership 30:11 CFO Role Shift Storytelling 32:48 Practical Takeaways and Wrap 36:22 Episode Closing

    38 min

  3. Apr 28

    Ep. 50 - Why Community Health Is a Smart Investment with Dr. Sylvia

    In this episode of "For the Love of Revenue Cycle," host Vanessa Moldovan speaks with Dr. Sylvia Owusu-Ansah, associate professor of pediatrics and emergency medicine at the University of Pittsburgh School of Medicine and EMS Medical Director at UPMC Children's Hospital of Pittsburgh, about what community engagement looks like in 2026 and why it's a smart investment for healthcare organizations. Dr. Sylvia (AKA Dr. O) shares examples sparked by the COVID era, including door-to-door outreach, language equity, and school-based pathway programs. They discuss why community initiatives are often treated as cost centers, how to measure impact through evaluation plans, and how community health can reduce costs by improving outcomes. Dr. O highlights measurable wins like CPR training that led to lives saved, emphasizes building trust with community leaders for sustainability, and offers calls to action for both community members and hospital leaders. 00:00 Welcome and Topic 01:28 Meet Dr Sylvia O 02:21 What Engagement Looks Like 03:19 Lessons From COVID 05:52 Why It Gets Ignored 07:19 From Research to Action 09:53 Workforce Pathway Programs 12:32 Measuring Impact 15:49 Data and Funding Sources 17:18 Building Trust Right 20:50 Sustainability and Support 25:46 Common Mistakes to Avoid 30:54 Calls to Action 34:45 Closing Thanks

    35 min

  4. Apr 15

    ViVE Replay: Building Better RCM Automation with Agentic AI

    ViVE Replay: Building Better RCM Automation with Agentic AI In this special episode, listen to Vanessa Moldovan present live at ViVE 2026. The talk covers identifying RCM and clinical-adjacent workflows ready for automation, ensuring automation solves rather than shifts problems, building CFO-ready ROI, implementing without disrupting operations, and using a framework to decide what to fix first. You'll learn more about high-impact automation areas (eligibility/benefits, prior auth, coding/claim review, payment integrity/contracts), get a clean explanation of agentic AI vs point solutions, hear about the six vendor-evaluation questions you need to ask, and discover what you should be tracking for ROI. After, you'll hear a panel of experts sharing real implementations and selection experiences, including Beacon's rapid care-gap outreach and MCR Health's focus on prior auth-driven cash flow. 00:00 Welcome and Intro 01:25 Session Goals Overview 03:37 Audience Poll 04:48 Why Change Now 05:56 Denials by the Numbers 07:28 Pain Across Ecosystem 10:30 Root Causes Breakdown 13:10 Path Forward and Panel 14:08 RCM Workflows to Automate 14:35 Standards and EDI Q&A 18:42 Ten Core RCM Steps 20:33 Top Automation Targets 26:36 Upstream Clinical Wins 28:11 Payer Side Opportunities 29:40 Agentic AI Explained 32:36 Vendor Questions Checklist 34:51 ROI Framework That Sells 38:39 KPIs That Prove Value 40:39 Tailored KPI Messaging 41:34 Fixing Workflows First 43:23 Agentic AI Reliability 48:19 Prioritization Framework 50:30 Meet the Panel 54:21 Beacon Care Gap Win 56:17 Choosing First Use Case 57:18 Buy In and Cash Flow 01:00:06 Data Quality and Trust 01:04:45 Compliance and Governance 01:08:35 ROI Metrics That Matter 01:10:20 PHI Learning and Feedback 01:16:12 Vendor Selection and Wrap Up

    1h 20m

  5. Mar 18

    FTLORC Live Denials Q&A! 03/10/26

    FTLORC Live Denials Q&A! 03/10/26 *Please note, the connection on the call dropped at the end, which is why there is a sudden cut-off. Vanessa Moldovan hosts a live community Q&A on denials and reimbursement, emphasizing end-to-end operational knowledge and root-cause fixes rather than siloed work. Nicolette shares a Medicare claim-rejection issue traced to offshore staff creating duplicate Medicare payer records with incorrect addresses, prompting new claim-entry guidelines. Participants discuss appeal effectiveness over sheer volume and trends in California denials, including Blue Shield requests for additional information and heightened scrutiny of 99213/99214 tied to fraud concerns and diagnosis ordering. Perva describes Medicare wellness/preventive denials for newly eligible members that required rebilling with 99214 instead of a G code and asks about Medicare crossover failures tied to patients updating secondary coverage with Medicare. Guadalupe details out-of-network underpayments driven by third-party pricing vendors like MultiPlan/Data iSight, ERISA-based appeal strategies, obtaining pricing in writing, NCCI/edit disputes, and escalation up to payer leadership. The group also covers documentation precision for time-based behavioral health codes and an orthopedic prior-authorization scenario where an authorized arthroscopy code was denied after a meniscectomy was coded, raising compliance and documentation questions. 00:00 Live Q&A Kickoff 00:55 Medicare Address Setup Errors 02:12 Root Cause Denial Fixes 04:46 99213 Denial Surge 06:57 Wellness Visit Coding Timing 09:09 Medicare Crossover Issues 10:50 Out of Network Underpayments 13:00 ERISA Appeals Strategy 16:40 Bundling and NCCI Disputes 21:05 Escalating to the CEO 24:53 Community Shoutouts and Teaching 26:28 Out Of Network Gap 28:03 Manual And LLM Help 29:05 Automation And Pricing Games 30:39 Multiplan Data Eyesight 32:32 Specialties And New Markets 33:36 Behavioral Health Denials 34:47 Time Based Documentation 36:42 Ortho Prior Auth Denial 42:15 Coding Billing Compliance 46:16 Wrap Up And Thanks

    47 min

  6. Feb 24

    Ep. 49 - Effective Strategies for Prior Authorization + Eligibility Verification

    In this episode of For the Love of Revenue Cycle, Vanessa breaks down why prior authorization and eligibility verification are two of the biggest drivers of preventable denials — and how getting them right is essential to clean claims and healthy cash flow. The discussion covers the foundations of payer requirements, the difference between denials and rejections, and where most revenue leakage actually occurs across the front end of the revenue cycle. Vanessa shares practical best practices for improving accuracy and efficiency in PA and EBV workflows, along with real industry data on denial trends. The episode also explores how modern technology, including agentic AI, is transforming these processes by reducing manual work, closing operational gaps, and shifting organizations from denial resolution to true prevention. 00:00 Welcome and Introduction 03:07 Understanding Clean Claims 06:04 Claim Requirements Explained 10:41 Denials vs Rejections 12:25 Why Prevention Matters 17:05 Front End vs Backend 22:05 Prior Authorization Deep Dive 26:28 PA Process Step by Step 29:34 Prior Authorization Best Practices 32:15 Eligibility and Benefit Verification 35:55 EBV Best Practices 38:52 Technology and AI Overview 42:30 Understanding Agentic AI 44:48 AI in PA and EBV Workflows 48:04 Closing and Call to Action

    49 min

  7. Feb 3

    Episode 48 : Rethinking Denial Management: What the Data Is Really Telling You

    In this episode of 'For the Love of Revenue Cycle,' the focus shifts from traditional denial management strategies to understanding the power of denial data. Vanessa discusses the limitations of current systems and common misconceptions in how denial management is practiced. Emphasizing the importance of prevention over mere resolution, the episode explains how analyzing denial data can reveal underlying process flaws and drive meaningful improvements. Key points include distinguishing between denial reasons and root causes, the importance of visibility over precision, and the role of technology in optimizing denial management. A call to action encourages listeners to rethink denial management as a strategic, data-informed approach to enhancing organizational performance.   00:00 Welcome and Introduction 00:15 Understanding Denial Management 00:58 The Role of Denial Data 05:14 Challenges in Using Denial Data 06:48 From Resolution to Prevention 07:49 Practical Steps for Denial Management 08:30 The Importance of Root Cause Analysis 10:07 Impact on Organizational Performance 11:46 Leveraging Technology and Automation 13:39 Conclusion and Final Thoughts

    15 min

  8. Jan 27

    Webinar Replay - Agentic AI in Revenue Cycle: Cutting Through the Hype

    In this special episode of 'For the Love of Revenue Cycle,' Vanessa Moldovan presents a recording of a recent webinar focused on the topic of Agentic AI. Approved by AAPC for one CEU, this episode dives into the reality of Agentic AI in revenue cycle operations. It explains what Agentic AI is, its difference from traditional automation or RPA, and how it addresses core issues like human error, payer complexity, and inadequate legacy technology. Practical, real-world applications in prior authorizations, eligibility verification, and document management are discussed, alongside the benefits of this technology. The importance of cautious and controlled adoption is emphasized, providing listeners with essential questions to evaluate vendors and ensure effective integration of Agentic AI into their workflows.   To claim your CEU, please submit the form here: https://forms.gle/J76NCbeXiyy6B5rC6   00:00 Introduction and Webinar Overview 00:49 The Reality of Agentic AI 01:56 Understanding Agentic AI 03:08 Challenges in Revenue Cycle 07:40 The Role of Agentic AI in Revenue Cycle 19:03 Evaluating Agentic AI Vendors 25:45 Implementing Agentic AI Safely 27:26 Conclusion and Next Steps

    30 min
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5
out of 5
25 Ratings

About

Did you ever wish that you had a physician revenue cycle expert and mentor with over 20 years of experience whispering success secrets in your ear? That's exactly what you will get when you tune into For the Love of Revenue Cycle hosted by me, Vanessa Moldovan. My career and my life have brought me a wealth of knowledge and I can't wait to share with you. My passion is to help others in the industry to reach their full potential and find success in the wonderful, crazy world of physician revenue cycle. Whether you are a beginner, expert, physician, consultant, educator or just plain curious, each episode is designed to immediately apply to your career, business and operations. Join me each week as we tackle the topics, trivia and triumphs of revenue cycle. Let's discover our full potential together.

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