The Claim Game

Jeremy and Kathryn Zug
  • 5.0 (2)
  • Management
  • Updated Weekly

The Claim Game podcast, hosted by Jeremy and Kathryn Zug, is designed to help healthcare providers navigate the complexities of revenue cycle management (RCM). Each episode aims to cut through confusion by breaking down complex billing processes and sharing real-world solutions. The podcast uses a "game board" metaphor to simplify the RCM landscape, offering strategies and practical tips to help practices "win" at revenue cycle management. Jeremy and Kathryn draw on their extensive experience to empower providers to take control of their revenue, turning claim denials into deposits and allowing them to focus more on patient care. The podcast covers key territories of billing, such as credentialing, patient registration, eligibility & benefits, payment posting, aging follow-up, and claim submission, with the ultimate goal of providing clarity in a confusing, frustrating, and outdated industry. jeremyzug.substack.com

  1. 5d ago

    Anne Neal on How Availity Is Reducing Claim Denials and Administrative Waste

    EPISODE SUMMARYIn this episode of The Claim Game, Jeremy Zug sits down with Anne Neal, Vice President of Product Management & Payment Integrity at Availity, to discuss the future of revenue cycle management. Together, they explore Availity's Abrasion Index, payment integrity, AI, prior authorization, and preventing claim errors before submission.. They also discuss fraud prevention, responsible AI, and the future of touchless claims processing. KEYWORDSAvaility, Revenue Cycle Management, Payment Integrity, Claims Management, Claim Denials, Prior Authorization, Healthcare AI, Payment Accuracy, Abrasion Index TAKEAWAYSPrevention Beats Correction: Preventing claim errors before submission reduces denials, appeals, administrative work and payment accuracy. Shared Challenges: Providers and payers face many of the same pain points, creating opportunities to collaborate. Payment Integrity Starts Early: Helping providers submit clean claims before submission improves reimbursement. Responsible AI: AI can streamline claims management and prior authorization when combined with transparency, governance, and human oversight. Touchless Claims: Automation, AI, and better data sharing are moving healthcare toward faster, more accurate reimbursement. CHAPTERS00:00 Introduction to Availity and Anne Neal's Journey 04:50 Availity's $4.5T Network Healthcare Network 09:37 Preventing Claim Errors 15:56 Prevention Over Clawbacks 22:40 What the Abrasion Index Reveals 26:40 What Is Payment Integrity? 29:50 Responsible AI in Healthcare 34:55 The Future of Touchless Claims 38:49 Innovation at the Speed of AI 40:43 Building a Better System Together RESOURCESToday Sponsors: Visit practicesol.com Visit availity.com  Availity’s Payment Integrity, Availity Extend, and Abrasion Index Anne Neal on LinkedIn The Claim Game Podcast The Hourglass Learning Hub. Practice Solutions Blog. Book: Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

  2. Aug 7

    Hemant Gupta on AI, Insurance, and the Future of Healthcare

    EPISODE SUMMARYIn this episode of The Claim Game, Jeremy Zug sits down with Hemant Gupta, physician advisor and former Chief Medical Officer at UnitedHealthcare, to explore the intersection of clinical care, insurance, and healthcare innovation. Together, they discuss why claim denials happen, how better documentation supports medical necessity, the structural challenges of value-based care, and how AI can reduce administrative burden while improving patient outcomes. Whether you're a provider, practice owner, or healthcare leader, this episode offers practical insights into building a more transparent, efficient healthcare system. KEYWORDSRevenue Cycle Management, Medical Necessity, Claim Denials, Physician Advisor, AI in Healthcare, Clinical Documentation, Prior Authorization, Value-Based Care, Healthcare Transparency, Utilization Management, Healthcare Innovation, Insurance Billing TAKEAWAYSBridge the Provider-Payer Gap: Strong documentation helps demonstrate medical necessity and supports appropriate reimbursement. Claim Denials Aren't One-Size-Fits-All: Different denial types require different prevention and resolution strategies. Better Documentation Matters: Clear, complete records reduce audits, strengthen claims, and support better patient care. Value-Based Care Needs Alignment: Lasting change depends on aligning providers, payers, data, and incentives. AI Should Reduce Friction: Used responsibly, AI can streamline documentation, speed approvals, and improve healthcare efficiency. CHAPTERS00:00 Introduction to Hemant Gupta's Journey 08:47 Closing the Gap Between Physicians and Payers 16:07 The Biggest Misconceptions About Insurance Denials 21:23 The Structural Barriers to Value-Based Care 35:45 Can AI Reduce Healthcare Friction? 42:53 Connect with Hemant Gupta RESOURCESToday Sponsors: Visit practicesol.com Connect with Hemant on LinkedIn Learn More About The Claim Game: Visit practicesol.com/podcast The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub. Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog. Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

  3. Jul 31

    Daniel Fava: The New SEO Strategy for Private Practice Websites

    EPISODE SUMMARYIn this episode of The Claim Game, Jeremy Zug sits down with Daniel Fava, founder of Private Practice Elevation, to discuss how your website can become an extension of your administrative team. Daniel shares how building his wife's therapy practice website led to an agency specializing in web design, SEO, copywriting, and digital strategy for private practices. Together, they explore how AI is changing SEO, why Google holds healthcare websites to a higher standard, and practical ways to improve your website. From creating helpful FAQ pages and clearly explaining insurance participation to building topic-focused content that attracts the right clients, this episode is packed with actionable advice for building trust, reducing confusion, and converting more website visitors into clients. KEYWORDSPrivate Practice SEO, Website Redesign, Revenue Cycle Management, Therapist Marketing, Insurance Clarity, AI Search Optimization TAKEAWAYSDirectories Get You Found; Your Website Gets You Chosen: Directories help prospective clients discover your practice, but your website is what builds trust and turns visitors into clients. Google Expects Expertise: Therapy websites fall under Google's YMYL (Your Money or Your Life) category, making trustworthy, high-quality content essential for SEO. Focus on Topic Depth: Create content that answers specific client questions instead of relying on keyword repetition. Reduce Intake Questions: FAQ pages, insurance information, and billing expectations eliminate confusion before a client reaches out. Clarity Improves Lead Quality: Listing pricing, insurance networks, and coverage details upfront attracts better-qualified leads. Invest in Strategic Copywriting: Strong messaging paired with SEO helps visitors feel understood and encourages them to schedule. CHAPTERS00:00 Meet Daniel Fava: From WordPress to Private Practice Websites 05:41 Is SEO Dead? How AI Is Changing Therapist Websites 12:01 Why Clear Website Messaging Wins More Clients 19:31 Why Therapist Bios Matter More Than You Think 23:45 The SEO Strategy Every Therapy Practice Needs 27:13 Directories Get You Found. Your Website Gets You Chosen. 30:37 How Therapist Websites Build Trust Before the First Session 35:31 How to Structure a Therapy Website That Converts 44:46 Final Advice for Building a Better Therapy Website RESOURCESToday Sponsors: Visit practicesol.com Learn More About Private Practice Elevation: Visit privatepracticeelevation.com Check out the Private Practice Elevation Podcast The Claim Game Podcast The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates. Practice Solutions Blog.

  4. Jul 24

    The AI Social Worker: Marina Badillo-Diaz on AI, Ethics & Mental Health

    EPISODE SUMMARYIn this episode of The Claim Game, Jeremy Zug sits down with Dr. Marina Badillo-Diaz, LCSW, founder of The AI Social Worker, to explore how artificial intelligence is transforming mental health and human services. Dr. Badillo-Diaz shares practical guidance on using AI ethically, protecting client privacy, and maintaining clinical judgment while embracing new technology. Together, they discuss AI documentation tools, HIPAA compliance, AI companions, and how therapists can confidently integrate AI into their practice without losing the human connection. TAKEAWAYSAI Should Support, Not Replace, Clinicians: Dr. Badillo-Diaz's "Co-Star" framework emphasizes that providers must review, edit, and guide AI outputs to preserve clinical judgment. Always Verify AI Documentation: AI scribes can save significant time, but every note should be carefully reviewed before becoming part of the client's record. Know the Risks of AI Companions: AI can improve administrative workflows, but relying on AI for emotional support raises important ethical concerns, especially for younger users. Use AI Transparently: The AI Assessment Scale encourages thoughtful, transparent AI use while recognizing when human expertise is essential. Choose Secure AI Tools: Paid, HIPAA-compliant platforms with Business Associate Agreements (BAAs) provide stronger privacy protections than free consumer AI tools. CHAPTERS00:00 Dr. Marina Badillo-Diaz's Background and Journey 10:38 Using AI in Therapy Without Losing the Human Touch 13:03 Beyond ChatGPT: Smarter Ways to Use AI 19:54 Choosing the Right AI Tool for the Job 27:11 The Risks of AI Becoming a Companion 39:09 Why AI Needs Human Oversight 40:50 Helping Therapists Embrace AI 46:43 Connect With Dr. Marina Badillo-Diaz RESOURCESToday Sponsors: Visit practicesol.com Learn more About The AI Social Worker: Visit theaisocialworker.com  Connect with Dr. Marina on LinkedIn Learn More About The Claim Game: Visit practicesol.com/podcast The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub. Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog. Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

  5. Jul 17

    How to Sell a Therapy Practice: Dan King on Valuation, M&A & Private Equity

    EPISODE SUMMARYIn this episode of The Claim Game, Jeremy Zug sits down with Daniel King of Fireside Strategic to explore the realities of healthcare mergers and acquisitions (M&A). Together, they discuss what makes a practice attractive to buyers, how valuations are really determined, and why factors like payer diversification, clinician retention, and operational readiness can significantly impact practice value. They also examine how AI is reducing administrative burden and helping practice owners build stronger, more sustainable businesses. TAKEAWAYSPractice Value Is About More Than EBITDA: Strong valuations come from reducing risk, maintaining healthy operations, and building a sustainable business—not chasing industry myths. Diversify Your Payer Mix: Heavy reliance on one insurance payer increases financial risk and can reduce your practice's appeal to potential buyers. Retention Drives Long-Term Value: Keeping clinicians engaged strengthens culture, improves patient continuity, and creates a more valuable organization. Prepare for Due Diligence: Buyers closely examine compliance, operations, and financial processes. Addressing issues early can protect your practice's value. Use AI to Reduce Burnout: AI is most effective when it supports clinicians by automating administrative work, allowing them to spend more time with patients. KEYWORDSPrivate Practice, Revenue Cycle Management, Practice Growth, Healthcare Business, Mental Health Billing, Medical Billing, Practice Valuation, Healthcare AI, Clinician Retention, Cash Flow CHAPTERS00:00 Welcoming Back Dan King 08:47 What Is Your Practice Really Worth? 12:03 What Investors Look for Before Buying a Practice 23:21 How Due Diligence Impacts Practice Value 29:25 Why AI Matters in Practice Growth 35:02 Conclusion: Buy, Sell & Grow with Confidence RESOURCESToday Sponsors: Visit practicesol.com Learn More About Fireside Strategic: Visit firesidestrategic.com Learn More About Your Group Practice Podcast: Visit yourgrouppractice.com Learn More About The Claim Game: Visit practicesol.com/podcast Email Dan: dan@firesidestrategic.com The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub. Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

  6. Jul 10

    Danny Freed on How Blueprint Is Reinventing the Mental Health EHR with AI

    EPISODE SUMMARYIn this episode of The Claim Game, Jeremy Zug sits down with Danny Freed, founder and CEO of Blueprint, to discuss how AI is transforming mental health practice management. Danny shares the personal journey that led him to healthcare, why Blueprint reimagined the traditional EHR model, and how AI is helping therapists spend less time on documentation and more time with clients. From automated billing workflows to real-time insurance eligibility and payer rate transparency, this conversation explores the future of efficient, therapist-first technology. TAKEAWAYSRethinking the Traditional EHR: Blueprint's approach is simple: the core EHR should be free, and providers should only pay for AI tools that save meaningful time. From Session to Submitted Claim in Minutes: Integrated AI can automate documentation, treatment plans, claim submission, and invoicing in just a few clicks. Clinical-Grade AI Matters: Effective healthcare AI relies on secure clinical data and context—not generic chatbot responses—to support therapists safely and accurately. Simplifying Insurance Eligibility: AI can translate complex eligibility data into clear, real-time coverage and out-of-pocket cost information for providers and clients. Bringing Transparency to Payer Rates: Benchmarking tools help therapists better understand market reimbursement rates and negotiate stronger insurance contracts. CHAPTERS00:00 Introduction: From a Personal Mission to a Full-Stack EHR 06:10 Building Around Therapists, Not Software Limitations 10:31 AI, Automation, and the Future of Therapy Billing 20:15 Clinical-Grade AI: Beyond Generic Chatbots 29:04 How Therapists Can Stop Accepting Below-Market Rates 32:12 Keeping Therapists at the Center of AI 37:52 Personalization at Scale: Training the AI Assistant 41:51 Conclusion: Better Tools, Better Care, Better Outcomes RESOURCESToday Sponsors: Visit practicesol.com Learn more About Blueprint: Visit blueprint.ai  Connect with Danny on LinkedIn Email Danny: danny@blueprint.ai Learn More About The Claim Game: Visit practicesol.com/podcast The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub. Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

  7. Jul 8

    Practice Audit: Danielle Hayes on Building a 150-Clinician Cash-Pay Therapy Practice

    EPISODE SUMMARYIn this episode of The Claim Game, Jeremy Zug sits down with Danielle Hayes, founder of Therapy Austin, to explore how she grew a cash-pay therapy practice from three clinicians to more than 140 providers across multiple locations. Danielle shares the leadership strategies, hiring philosophies, and operational systems that supported sustainable growth, along with lessons on clinician development, practice culture, and selling a successful therapy business. Whether you're building your first team or planning your long-term exit strategy, this episode is full of practical insights for practice owners. KEYWORDSGroup Therapy Practice, Therapy Austin, Private Practice Growth, Practice Leadership, Selling a Therapy Practice, Behavioral Health Business, Practice Operations, Private Practice Coaching, Healthcare Entrepreneurship TAKEAWAYSInvest in Clinician Development: Strong onboarding, mentorship, and leadership opportunities help clinicians grow while improving retention and practice stability. Culture Is Your Competitive Advantage: Shared values and a supportive environment create consistency, strengthen teams, and drive long-term growth. Hire for Character: Skills can be taught, but curiosity, accountability, and values alignment are essential for building a successful team. Growth Requires Systems: Scaling a practice means shifting from founder-driven relationships to structured processes, leadership, and operational excellence. Selling Takes Preparation: Successful practice sales require realistic expectations, careful planning, and finding a buyer who shares your vision. Patience Wins: Sustainable growth comes from focusing on quality, consistency, and long-term goals—not chasing every new opportunity. Build Strong Referral Networks: Trusted advisors and industry relationships provide valuable guidance as your practice grows. CHAPTERS00:00 Introduction: From Solo Practice to a Mentorship-Driven Team 06:11 The Therapist Growth Mindset: Investing in Your Craft 14:33 The Shift from Relationships to Systems 17:26 Hiring for Character, Training for Skill 28:22 When It Was Time to Sell 33:17 Selling a Practice: More Than Just the Numbers 38:55 Conclusion: Patience Is the Ultimate Growth Strategy RESOURCESToday Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO Email Danielle at danielle@hayestherapy.net  Learn More About The Claim Game: Visit practicesol.com/podcast The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub. Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog.

  8. Jul 8

    Practice Audit: Building a Multi-Location Therapy Practice with Shannon Hiser

    EPISODE SUMMARYIn this episode of The Claim Game, Jeremy Zug sits down with Shannon Hiser, founder of The Wellness Counseling Center LLC, to discuss the realities of scaling a multi-location therapy practice. Shannon shares the administrative and compliance challenges that tested her business—from staffing turnover and insurance audits to billing setbacks—and how she built a reliable in-house billing system with the help of Practice Solutions. Together, they explore practice growth, leadership, AI in healthcare, and creating a business that aligns with your values. KEYWORDSRevenue Cycle Management, Private Practice Scaling, Insurance Audits, W2 Therapists, 1099 Therapists, Supervisory Billing, In-House Billing, Practice Management Software, Value-Based Business TAKEAWAYS1099 vs. W2 Matters: Understanding worker classification is essential when clinicians bill under your Tax ID. Misclassification can lead to costly audits and compliance issues. Verify Insurance Policies in Writing: Don't rely on verbal guidance from payer representatives. Always confirm billing rules through contracts and provider manuals. Build a Business That Doesn't Depend on You: Sustainable growth requires systems and infrastructure—not an owner carrying an unsustainable caseload. Use AI Thoughtfully: AI can reduce administrative burden through documentation and billing support, giving providers more time to focus on patient care. Lead with Your Values: When challenges arise, solve problems one step at a time while keeping your practice aligned with your mission and long-term goals. CHAPTERS00:00 Introduction to Shannon Hiser and The Wellness Center 12:27 Navigating Administrative Storms and Compliance Challenges 26:58 From Founder-Dependent to Future-Ready 29:50 The AI Dilemma: Efficiency vs. Ethics 34:57 Growing the Team Without Compromising the Mission 37:14 Conclusion: Lead with Values, Not Just Goals RESOURCESToday Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO Learn More About The Wellness Counseling Center Learn More About The Claim Game: Visit practicesol.com/podcast The Hourglass Learning Hub: Dive deeper into RCM best practices and downloadable tools mentioned in this episode, like the various checklists and templates, by visiting The Hourglass Learning Hub. Our Blog: Explore years of educational articles on billing and practice management at Practice Solutions Blog. Book: For a comprehensive guide on navigating insurance, grab your copy of Insurance Billing Basics: Steps for Therapists to Successfully Take Insurance.

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About

The Claim Game podcast, hosted by Jeremy and Kathryn Zug, is designed to help healthcare providers navigate the complexities of revenue cycle management (RCM). Each episode aims to cut through confusion by breaking down complex billing processes and sharing real-world solutions. The podcast uses a "game board" metaphor to simplify the RCM landscape, offering strategies and practical tips to help practices "win" at revenue cycle management. Jeremy and Kathryn draw on their extensive experience to empower providers to take control of their revenue, turning claim denials into deposits and allowing them to focus more on patient care. The podcast covers key territories of billing, such as credentialing, patient registration, eligibility & benefits, payment posting, aging follow-up, and claim submission, with the ultimate goal of providing clarity in a confusing, frustrating, and outdated industry. jeremyzug.substack.com

Information

  • Creator
    Jeremy and Kathryn Zug
  • Years Active
    2025 - 2026
  • Episodes
    59
  • Rating
    Clean
  • Copyright
    © 2026 Jeremy and Kathryn Zug
  • Show Website
    The Claim Game

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