RCM ReFramed

GetixHealth
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Welcome to RCM ReFramed, the podcast dedicated to reshaping traditional views and approaches to Revenue Cycle Management (RCM) through innovative frameworks and strategic insights. Join us for the latest innovations, expert interviews, and discussions that will help enhance your RCM processes and shape the future of healthcare finance.

Выпуски

  1. 26 июн.

    Turning Coding Needs into Coding Success with AI-RCM Reframed

    Autonomous coding doesn't fail because of the AI. It fails because of weak documentation, undocumented logic decisions, and missing physician engagement. Kelly Pearson, Director of Coding and CDI at MercyHealth, joins RCM Reframed to share the operator playbook behind their autonomous coding rollout, including what she would do differently with a second chance. Kelly walks through the operational pain points that drove MercyHealth to AI (coder shortages, pre-AR delays, backlog pressure), how the team assessed AI readiness through documentation quality, and why a layered audit model with 100% review at go-live was non-negotiable. She also explains the four-month implementation moment that prompted MercyHealth to create a dedicated coding project manager role, and how provider trending data is now driving targeted physician education. What you will take away: * Why documentation readiness, not AI capability, determines success * How to structure a layered audit model that scales without removing oversight * Why a dedicated coding project manager is essential from day one * How to engage physician advocates early and use AI trend data for targeted education * The future of the coder role: validation, analytics, education, and AI governance Subscribe for more conversations with revenue cycle operators who've actually done the work. Learn more about GetixHealth: getixhealth.com Connect with Kelly Pierson: https://www.linkedin.com/in/kelly-pierson-cpc-crc-499848145/

    25 мин.

  2. 29 мая

    Beyond Bots: What Rev Cycle Leaders Need to Rethink about AI.

    What does an actual RCM automation roadmap look like when it's built by operators, not vendors? Michael Laukaitis, Director of Revenue Cycle, Analytics, Accounting, and Quality Assurance at UT Southwestern, walks through the sequence his team followed over eight years: reporting first, then workflow analysis, then RPA, then AI, then agents. The result: roughly $4.5 million in FTE-equivalent savings over six years, including $1.5 million in the last year alone. The team built an AI agent named Sophie that surfaces SOPs, answers workflow questions, and compares Epic upgrade documents against existing procedures to flag what needs review. Their first agents handling Epic functionality and denials management are coming online in the next month and a half. Michael's warning to providers: he points to a 2016 Microsoft presentation that convinced him payers were already using automation and AI. Many provider RCM teams are still appealing those denials manually. As he put it: "The one thing I've seen organizations that have failed do is to just put bots in just to have bots." What you'll get from this conversation: * The reporting → analysis → RPA → AI → agents sequence, and why skipping steps creates "emotional support bots" * How Lean Six Sigma, Gemba walks, and the five whys come before any UiPath build * Why the SOP library is operational infrastructure, not a documentation chore — and how it became the foundation for an AI agent * A Medicaid coverage retrieval example: four staff handling roughly 16,000 accounts every three months versus a bot that could do the same workload every 16 days, with implications for timely filing and self-pay conversion * How to drive AI adoption with skeptical staff by anchoring on their three biggest weekly frustrations, not strategy slides * The case for embedding analytics in operations while strictly following IT governance * How to safely build AI literacy on a personal GPT when your security team hasn't approved enterprise access A practical playbook for anyone who owns denial rate, AR days, or net revenue yield. 🎙 Subscribe to RCM Reframed for more conversations with RCM operators. 🔗 Learn more: https://insights.getixhealth.com/podcast/beyond-bots 💼 Connect with Michael Laukaitis: https://www.linkedin.com/in/mikelaukaitis/

    36 мин.

  3. 24 апр.

    The Impact of Experience Across the RCM Landscape-EP 7

    In this insightful conversation, host Shawn Gretz, President, Sales and Marketing for GetixHealth, sits down with Sandra Gubbine, Assistant Vice President, Revenue Cycle at AtlantiCare and discusses a wide variety of topics that touch on leadership in revenue cycle and more. Discussing everything from how Sandra found her way into healthcare, system conversions, and managing people in diverse areas of healthcare, to mentoring the next generation of leaders and volunteering, Shawn and Sandra explore issues that impact the healthcare revenue cycle and beyond.

    1 ч. 10 мин.

  4. 06.11.2024

    Leading Through Change: Insights from Miguel ‘Mike’ Vigo, VP of Revenue Cycle at UC San Diego Health

    In this engaging discussion, Beth interviews Miguel “Mike” Vigo, the Vice President of Revenue Cycle at UC San Diego Health, who shares insights from his first two years in the role. Mike highlights how he prioritized building relationships with his leadership team, implemented effective communication practices, and successfully integrated newly acquired hospitals while preserving a cohesive team culture. He also reflects on the challenges of adapting to California’s unique regulatory landscape compared to his previous experience in Illinois. Through open communication, trust, and a shared vision, Mike has successfully led UCSD Health through significant growth and change, keeping his team aligned and thriving.

    17 мин.
  5. Compliance in New Financial Assistance Laws: Mandatory Screening, Presumptive Eligibility, and Reporting Challenges for Revenue Cycle Leaders

    06.11.2024

    Compliance in New Financial Assistance Laws: Mandatory Screening, Presumptive Eligibility, and Reporting Challenges for Revenue Cycle Leaders

    In this podcast, Cheryl speaks with Laura Robbins, Chief Compliance Officer and Chief Operating Officer at Advocatia, about the recent legislative focus on expanding financial assistance programs in healthcare. They explore the motivations behind this push, common themes in state laws, and the challenges providers face in implementing these programs. Laura provides insights on presumptive eligibility screening, patient engagement, and industry best practices for workflows related to financial assistance. She underscores the importance of partnering with trusted providers who offer scalable technology solutions while maintaining a multi-channel approach to accommodate diverse patient preferences.

    14 мин.
  6. Building Payer Relationships, Aligning Teams, and Preparing for Cybersecurity Threats – Insights for RCM Leaders

    06.11.2024

    Building Payer Relationships, Aligning Teams, and Preparing for Cybersecurity Threats – Insights for RCM Leaders

    n this insightful discussion, Evan, a seasoned revenue cycle consultant, shares his perspective on the top challenges facing revenue cycle leaders today. From navigating ever-changing payer requirements to managing cybersecurity risks, Evan explains his approach to evaluating an organization’s revenue cycle health and developing effective strategies for improvement. He highlights the value of investing in team education, fostering strong payer relationships, and proactively preparing for potential system disruptions. Evan’s real-world experience offers valuable lessons for revenue cycle professionals at every level.

    27 мин.
  7. Insights from a Revenue Cycle VP: Establishing Operations at a New Organization

    06.11.2024

    Insights from a Revenue Cycle VP: Establishing Operations at a New Organization

    In this insightful discussion, Amanda, the Vice President of Revenue Cycle at ValleyWise Health, shares her experience leading revenue cycle operations over the past 18 months at a new organization. She highlights how she prioritized key initiatives, built a strong leadership team, improved cash flow, and navigated challenges posed by a complex payer mix. Amanda also emphasizes the importance of holding payers accountable, identifying denial trends, and maintaining open communication. Looking ahead, she expresses excitement about upcoming projects, including an Epic refuel, aimed at further optimizing their revenue cycle processes.

    18 мин.

  8. 03.10.2024

    Insights from Chief Information Officers in Healthcare

    In this panel discussion, CIOs from major healthcare organisations tackle key challenges in healthcare IT, including cybersecurity breaches and the role of AI in transforming patient care. Featuring power names in Healthcare industry David Stuart (CTO at Getixhealth) Follow : https://www.linkedin.com/in/david-stuart-58807a6/ Matt Chambers (CIO at at Baylor Scott & White Health) Follow: https://www.linkedin.com/in/matthewchambers/ William "Bill" Phillips (VP/CIO University Health) Follow: https://www.linkedin.com/in/william-phillips-ab18047/ Eric Ried (VP/CTO CHRISTUS Healthcare) Follow: https://www.linkedin.com/in/ericlried/

    1 ч. 28 мин.
  • Выпусков: 8

Об этом подкасте

Welcome to RCM ReFramed, the podcast dedicated to reshaping traditional views and approaches to Revenue Cycle Management (RCM) through innovative frameworks and strategic insights. Join us for the latest innovations, expert interviews, and discussions that will help enhance your RCM processes and shape the future of healthcare finance.

Информация

  • Автор
    GetixHealth
  • Годы выхода
    2024 - 2026
  • Выпуски
    8
  • Ограничения
    Без ненормативной лексики
  • Авторские права
    © GetixHealth
  • Сайт подкаста
    RCM ReFramed