RCM ReFramed

GetixHealth

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Entrepreneurship
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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.

3d ago

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 min
Apr 24

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.

1h 10m
11/06/2024

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 min
11/06/2024

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 min
11/06/2024

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 min
11/06/2024

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 min
10/03/2024

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/

1h 28m

7 Episodes

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.

Creator

GetixHealth
Years Active

2024 - 2026
Episodes

7
Rating

Clean
Copyright

© GetixHealth
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RCM ReFramed