The Claim Game

Jeremy and Kathryn Zug
  • 5.0 (2)
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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aging follow-up, and claim submission, with the ultimate goal of providing clarity in a confusing, frustrating, and outdated industry.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. 1D AGO

    Claim Submission for Private Practices: Avoid Denials & Get Paid Faster

    EPISODE SUMMARY Is your practice tired of wrestling with insurance denials and watching hard-earned revenue slip through the cracks? In this episode of The Claim Game, Jeremy Zug goes upstream to the "point of inception": Claim Submission. While many providers view submitting a claim as a simple keystroke, Jeremy challenges that rudimentary thinking. He breaks down why claim submission is actually a sophisticated discipline of translation—where your clinical work is converted into the rigid, bureaucratic data points that insurance carriers demand. If your translation is off by a single letter, you’ve essentially engineered a cash flow crisis 90 days down the line. Tune in to learn the four critical tools you need to master this domain, move from clinical logic to billing logic, and ensure your "last stop" internal process leads to a deposit, not a denial. KEYWORDS Revenue Cycle Management, Claim Submission, Medical Billing, Private Practice, Insurance Denials, RCM, Healthcare Administration, Billing Logic, Practice Management TAKEAWAYS Claim Submission is Translation: It is the bridge between clinical logic (I treated the patient, I should get paid) and billing logic (you followed the rigid rules or you forfeit payment). The "Two-Centimeter" Rule: A tiny administrative error at the point of submission can spiral into a $2,000 problem 90 days later. Modifiers are Not Optional: View modifiers as vital context, not optional adverbs. Without correct codes and modifiers, a claim is "dead on arrival". The Pre-Flight Discipline: Never risk a week's worth of revenue on a hypothesis. Test new payers or providers with a single claim, verify it pays, and then scale. Data Over Drama: Rejections and denials aren't personal; they are diagnostic data points. Use them to reroute your strategy rather than just feeling frustrated. Revenue vs. Mission: A financially fragile practice can help very few people. Maximize your contracted rates to ensure your mission remains sustainable. CHAPTERS 00:00 Introduction: The Territory of Claim Submission 03:28 Why Small Errors Become Big Denials 05:16 Learning the Language of Billing 08:20 The Pre-Flight Checklist for Claims 12:57 Rejections Are Data, Not Defeat 14:51 Navigating Insurance Rate Negotiations 17:48 Case Study: The Telehealth Modifier Crisis 20:21 Conclusion: What You’re Really Searching For Is Freedom RESOURCES Today Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO 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. Images: Claim Information Review Guide, Modifier Usage Guide, Rate Increase Notification, Rejection Resolution Guide, Claim Management Spreadsheet Get full access to The Claim Game at jeremyzug.substack.com/subscribe

    25 min

  2. MAY 8

    Scaling a Group Practice: Hiring, Systems & Leadership with Jamey Schrier

    EPISODE SUMMARY Is your practice a "Jamey Show" or a sustainable business? In this episode, Jeremy sits down with Jamey Schrier, PT, and founder of Practice Freedom U, to discuss the messy, often painful transition from "solopreneur" to professional business owner. Jamey shares the raw story of his practice burning to the ground—literally—and why that disaster was actually the "snow day" he needed to realize he was building a prison, not a business. We dive deep into the "Mindset Upgrade" required to stop solving the same billing and hiring problems over and over again. If you’ve ever felt like an expert clinician but a struggling amateur in business, this episode is your roadmap to turning "always effing something" into an unfair advantage. KEYWORDS Practice Management, Physical Therapy, Revenue Cycle Management, Entrepreneurship, Practice Owner, Mindset Shift, Business Scaling, Hiring Best Practices, Credentialing, Healthcare Leadership TAKEAWAYS The "Pulse Optional" Hiring Trap: Most practice owners hire out of desperation (the "warm body with a pulse" method). Success requires slowing down the process and hiring based on values and clear systems rather than gut instinct. The Three Pillars of Practice: A healthy business needs Structure (the nails and roof), a Financial Model (the KPIs), and Mindset (the leader’s internal operating system). If your mindset is stuck in "Control" or "Limited Beliefs," the other two pillars will eventually crumble. Hire Slow, Fire Fast: We often do the opposite—hiring fast in a panic and taking forever to let go of a bad fit. If you can tell on day one that someone isn't the right fit, your ego shouldn't stop you from making the tough call. The 80/20 Energy Audit: Identify the 20% of tasks that drain your energy and produce the least revenue. Delegate those to someone who loves doing what you hate (like billing!) so you can stay in your "sweet spot." The Professional vs. The Amateur: Being a "pro" means stepping out of the day-to-day "clinician" role once your revenue hits a certain threshold (typically $800k+) to protect the bigger picture and implement safety systems. CHAPTERS 00:00 Building a Coaching Team 00:59 Introduction: From Burnout to Breakthrough 11:15 The Journey of Coaching and Business Growth 13:20 When Mistakes Become Your Best Teacher 17:39 Learning Payroll, HR, and Leadership the Hard Way 22:52 Choosing Growth Over Victimhood 26:29 The 80/20 Rule and Business Efficiency 31:46 Structure, Model, Mindset: The Missing Piece 39:24 Conclusion: The ROI of Doing the Work RESOURCES Today Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO Practice Freedom U: Jamey Schrier’s Coaching & Training  Connect with Jamey 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. Get full access to The Claim Game at jeremyzug.substack.com/subscribe

    45 min

  3. MAY 1

    4 Billing KPIs Every Mental Health Practice Must Track

    EPISODE SUMMARY Are you running a practice, or are you just moving pieces around a board while your bank account stays empty? In this episode, Jeremy Zug dives into the high-tangible world of Revenue Cycle Management (RCM) to discuss the vital signs of your practice’s financial health. As a clinician, you might be used to the "wait and see" approach in a therapy session, but in the billing world, "wait and see" is a slow-motion train wreck. Jeremy breaks down the four essential Key Performance Indicators (KPIs) that act as diagnostic tools for your business. From the "perishable good" that is your insurance aging report to the uncomfortable but necessary conversations around patient balances, this episode is a masterclass in shifting from a "starving artist" trope to a "money mind" that wins. KEYWORDS Private Practice, Revenue Cycle Management, Insurance Billing, KPIs, Mental Health Billing, Cash Flow, Practice Growth TAKEAWAYS The 90-Day Rule: Money is a perishable good. In 2026, a healthy practice should have less than 15% of its total accounts receivable in the 90+ day bucket. After 90 days, the probability of collection doesn't just dip—it collapses. Process vs. Billing Problems: If your patient aging is spiking, it’s usually a front-end process issue. Are you verifying eligibility before the first session? Waiting 90 days to tell a client they owe $500 is unprofessional and erodes the clinical trust you've built. The 5% Denial Benchmark: While the industry average for mental health is near 15%, you should aim for a denial rate at or under 5%. If you’re at 20%, you aren’t billing insurance—you’re a pen pal with a computer programmed to ignore you. Speed is Leverage: Resolution on denials (appealed, resolved, or closed) should happen within 72 hours. Insurance bureaucracy is built on the hope that you’ll get tired and go away; speed is your only real leverage. The Clean Report Mirage: Don't let a "perfect" aging report fool you. Verify your net collection rate against what is actually arriving in your bank account to ensure the data isn't being manufactured to look clean. CHAPTERS 00:00 Introduction: The Hidden Tension Between Care and Cash Flow 03:11 KPI #1: Measuring What You’re Owed (Before It Disappears) 05:39 KPI #2: Managing Patient Receivables Effectively 06:57 KPI #3: Denial Rate and Claim Performance 09:10 KPI #4: How Fast You Resolve Denials 10:15 Case Studies: Two Practices, One Hidden Problem 12:59 Practice Owners: Focus on Care, Not Claims 14:18 Conclusion: Building a Measurable, Sustainable Practice RESOURCES Today Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO 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. Images: Aging Follow-up KPI Dashboard Get full access to The Claim Game at jeremyzug.substack.com/subscribe

    16 min

  4. APR 24

    Practice Audit: Meg Wright of Maitri on Scaling a Therapy Practice & Solving AR Problems

    EPISODE SUMMARY In our second-ever practice audit, we’re heading up north—way up north. We’re joined by Meg Wright, a licensed professional counselor and the visionary behind Maitri Holistic Therapy and Wellness in Homer, Alaska.  Meg has built a thriving practice based on the Sanskrit concept of maitri—developing an unconditional friendship with yourself. But even with a successful practice and a "land-informed" perspective on trauma, Meg found herself facing a "perfect storm" when she transitioned from a solo practitioner to a group practice owner.  From the "bureaucratic abyss" of credentialing in rural Alaska to the technical wobbles of switching EHRs, Jeremy and Meg dive deep into the "nuts and bolts" of her practice. They discuss the grit required to run a business when you aren't paying yourself yet, and how to have those uncomfortable—but clinically vital—conversations about money with your clients.  KEYWORDS Private Practice, Revenue Cycle Management, Group Practice, Insurance Billing, Mental Health Billing, Alaska Healthcare, EHR Transition, Accounts Receivable, Credentialing, Healthcare Business TAKEAWAYS The "Group Practice Learning Curve": Moving from solo to group isn't just "solo tenfold"—it requires a total overhaul of your systems, from marketing to your EHR. The Data Transfer Trap: When switching EHRs, remember that sensitive data like credit card numbers often don't transfer. Plan for a "bridge period" where you manually re-collect this info to avoid an AR nightmare. Reciprocity as Culture: In remote areas like Alaska, survival depends on looking out for one another. Meg has successfully infused this "we stop for people" mentality into her clinical team. Money is a Clinical Conversation: Discussing balances and insurance changes isn't just "business"—it’s an opportunity for authenticity and growth in the therapeutic relationship. The "Meg Plan" for Growth: Don't try to outsource everything at once. Be intentional: master a task yourself first, then hire someone to take that specific "headache" off your plate each year.  CHAPTERS 00:00 Alaska's Unique Climate and Lifestyle 02:53 Meg's Journey to Private Practice 05:58 Therapeutic Approaches in Alaska 08:57 Challenges of Running a Group Practice 12:01 Navigating EHR Transitions 15:01 Insurance Dynamics in Alaska 17:54 Financial Management and Growth Strategies 29:11 Creating Effective Processes for Client Communication 32:46 Navigating Difficult Conversations with Clients 36:18 Understanding the Impact of Insurance Changes 39:50 Streamlining Administrative Processes 43:02 Building a Supportive Team Culture 46:14 Leveraging Resources for Practice Growth 51:12 Strategies for Improving Accounts Receivable RESOURCES Today Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO Maitri Holistic Therapy and Wellness: Visit Meg’s Website 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. Get full access to The Claim Game at jeremyzug.substack.com/subscribe

    56 min

  5. APR 17

    Insurance Claim Denials: How to Appeal and Get Paid Faster

    EPISODE SUMMARY ​​In this episode of The Claim Game, host Jeremy Zug breaks down one of the most misunderstood and frustrating domains of the revenue cycle: Appeals. While many providers’ knee-jerk reaction is to fight every denial with a passionate letter, Jeremy explains why an appeal should actually be your fifth line of defense, not your first. We’re pulling back the curtain on how insurance companies actually process these requests and giving you a systematic, five-phase playbook to turn those denials into deposits. KEYWORDS Revenue Cycle Management, Appeals, Eligibility Verification, ERA, EOB, Corrected Claim TAKEAWAYS The "Fifth Line" Philosophy: An appeal is a last resort. Most denials can and should be resolved much earlier in the aging follow-up stage with a simple corrected claim or a phone call. The Eligibility Trap: Don’t rely solely on your EHR’s automated tools. They are notoriously inaccurate and can lead to major downstream "heartaches" like clawbacks. Research is Your Intelligence: Never assume Payer A’s rules are the same as Payer B’s. Requirements vary by company and by state—if you don't know the specific workflow, pick up the phone and ask. Evidence Wins, Not Stories: A long-winded letter about "fairness" rarely gets read. Your appeal is a legal-style process that needs objective evidence: EOBs, prior authorizations, correspondence logs, and clinical notes. Track the Five Milestones: Don’t just send it and hope. Track your appeal through: Received, Under Review, Processed, Decision Made, and Final Payment. CHAPTERS 00:00 Introduction: Where Appeals Fit in the Revenue Cycle 02:24 Appeals Are Not Your First Move 06:39 The Appeals Playbook Begins 08:10 Phase 2: Proper Appeal Formatting 09:19 Phase 3: Evidence Wins Appeals 10:04 Phase 4: Track It or Lose It 11:13 Phase 5: Build Your Appeals Playbook 11:53 Conclusion: Take Control of Your Appeals Process RESOURCES Today Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO 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. Images: Appeals Packet Get full access to The Claim Game at jeremyzug.substack.com/subscribe

    14 min

  6. APR 10

    Practice Audit: Inside Tri-Star Counseling’s Billing, Intake & Revenue Strategy

    EPISODE SUMMARY Is your private practice’s front office running like a well-oiled machine, or a "clogged emotional drain"? This week on The Claim Game, Jeremy Zug sits down with Brent Metcalf, LCSW, founder of Tri-Star Counseling, to discuss the wild ride of scaling a multi-niche group practice in the Appalachian region. Brent shares the "serendipitous" story of how he was essentially "voluntold" into private practice by his financial advisor and how he grew that accidental start into a thriving team of 11 clinicians. We dive deep into the "hodgepodge" of patient registration—the common headaches of missing insurance cards, tech-averse clients, and the "ickiness" therapists often feel when charging for their time. Whether you’re curious about the strategy behind buying a commercial building or wondering if AI note-taking is the "magic" your documentation needs, Brent’s "Dr. Brent" wisdom offers a masterclass in balancing clinical heart with a "business hat" mindset. KEYWORDS Private Practice, Revenue Cycle Management, Mental Health Billing, Appalachia, Group Practice Growth, Patient Registration, Medical Billing, Healthcare Business, Credentialing, Therapy Notes, Jane App, AI Notes TAKEAWAYS The "Voluntold" Entrepreneur: Brent’s journey proves that sometimes the best business moves happen when you stop overthinking and start saying "yes" to the opportunities that fall into your lap. Registration is the Foundation: A "C-grade" registration process leads to "BAM—denied" claims. Collecting front-and-back insurance card images before the first session is non-negotiable for clean eligibility checks. Mindset Over Money: Charging co-pays and no-show fees isn’t "mean"—it’s essential. If you want to provide high-quality care to underserved regions, you have to keep your own lights on first. Scaling with Culture: Tri-Star uses a "finder's fee" for employees to recruit peers they actually want to work with, ensuring the "open-door policy" stays authentic as the team grows. The Power of Commercial Real Estate: Instead of renting forever, Brent invested in a 20-office building, turning empty space into a "one-stop wellness shop" with massage therapy and psychiatric NPs. AI as a Clinical Ally: Transitioning from "anti-AI" to an advocate, Brent uses AI scribing to stay present with the human on the couch rather than buried in a notebook. CHAPTERS 00:00 Introduction: Meet Brent Metcalf and Tri-Star Counseling 07:33 Why Patient Registration Keeps Slowing You Down 11:37 Improving Intake Through Training and Process 17:48 Culture, Compliance, and Client Experience 22:38 Scaling the Practice: Growth, Real Estate, and Expansion 30:50 Building Community Presence and Referral Networks 32:27 Beyond the Practice: Teaching, Supervision, and Consulting 33:51 Navigating Insurance, Access, and Practice Economics 38:11 Advice for Starting and Scaling a Practice 41:56 Leveraging AI for Notes and Treatment Planning 44:32 Conclusion: Final Insights for Practice Success RESOURCES Today Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO Learn More About Tri-Star Counseling: tri-starcounseling.com Upheal: https://upheal.io/join?via=YKWVPJ74 Heard: https://affiliate.joinheard.com/ucv1vp09xwra 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. Get full access to The Claim Game at jeremyzug.substack.com/subscribe

    48 min

  7. APR 3

    Insurance Claim Follow-Up: How to Manage Aging Claims and Get Paid Faster

    EPISODE SUMMARY In the world of Revenue Cycle Management (RCM), ignoring your aging report is like planting a garden and never pulling the weeds—eventually, you’ll lose your harvest. Jeremy Zug walks us through the anatomy of an aging report, defining the levels of urgency for claims sitting in 30, 60, and 90-day buckets.  We discuss the critical difference between a rejection and a denial, how to calculate your "Days in AR," and why your EHR might be holding your financial health hostage. This episode is all about moving from frustration to traction by treating your AR follow-up like an appointment you’d never cancel.  KEYWORDS Revenue Cycle Management, RCM, Aging Report, Days in AR, Claim Denials vs. Rejections, Batching, Timely Filing Limits, Electronic Health Record, EHR TAKEAWAYS Know Your Buckets: Think of your aging report as a map of urgency. The 31–60 day range is your "Goldilocks zone" for follow-up—not too early to be annoying, but not too late to be ignored. The 90-Day Danger Zone: Anything over 90 days is "where money goes to die." Waiting until a claim hits this mark to check in means you’re likely bumping up against timely filing limits and appeals deadlines. Batching is the Secret to Scaling: Don't chase the oldest claim first. Sort your report by payer and handle 10 claims in one call or portal login. It maximizes efficiency and minimizes your time on hold.  Always Get a Receipt: Never end a call with a payer representative without a call reference number. It forces accountability and serves as your "save point" if you have to call back.  Consistency Over Intensity: Small weeds are easy to pull; a 90-day forest is a nightmare to clear. Block out dedicated time (at least two hours) weekly to manage your aging.  CHAPTERS 00:00 Introduction: Why Aging Follow-Up Matters for Your Claims 02:36 Breaking Down the Aging Report 08:53 Building a System for Aging Claim Follow-Up 13:16 Case Study: Solving an $8,000 Aging Claim Problem 14:16 Conclusion: Key Takeaways for Managing Aging Claims RESOURCES Today Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO 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. Images: Claim Management Spreadsheet Get full access to The Claim Game at jeremyzug.substack.com/subscribe

    17 min

  8. MAR 27

    Fixing Prior Authorization in Healthcare with Dr. Jeremy Friese

    EPISODE SUMMARY In this episode, Jeremy Zug takes a strategic pause to interview a true healthcare game changer: Dr. Jeremy Friese, founder and CEO of Humata Health. Dr. Friese isn't just a tech executive; he’s a "recovering Mayo Clinic physician" who spent two decades in the trenches as an interventional radiologist. After witnessing the systemic failures of healthcare during his mother’s battle with cancer, he dedicated his career to fixing the "broken fax machine" of the industry. We dive deep into the world of Prior Authorization—the ultimate bottleneck in patient care. Dr. Friese explains how Humata is using AI to turn administrative friction into a thing of the past, reducing provider burnout and ensuring that "Barb the nurse" can get back to what she does best: caring for patients. We explore the "AI arms race," why payers actually want providers to have better technology, and how the new CMS regulations are acting as a regulatory tailwind for the entire industry. KEYWORDS Prior Authorization, Revenue Cycle Management, Health Tech, AI in Healthcare, Medical Billing, Practice Management, CMS 0057, Provider Burnout, Healthcare Innovation TAKEAWAYS Prior Auth is the Ultimate Bottleneck: It is the "middle of the hourglass" in the revenue cycle. If you don't get the authorization right, you can't deliver care, and you certainly won't get the claim paid. The "Business of Yes": AI isn't just about automation; it's about getting to a "yes" more efficiently. Between 20% and 40% of authorizations submitted are for services that don't even require one—technology can eliminate that wasted effort instantly. The AI Arms Race is a Myth: In the world of prior auth, the opposite is true. Payers actually benefit when providers use advanced technology because it reduces the administrative burden on their end to review manual, 100-page clinical faxes. The "Gray Zone" of Medicine: While AI will likely handle 90% of submissions in the next five years, the "practice of medicine" will always have a gray zone that requires a human expert to interpret complex medical policies. Post-Authorization Monitoring: Life changes in the 30 days between an approval and a surgery. If the CPT code or site of service shifts even slightly, you’ll face a denial on the back end unless you are constantly monitoring that auth status. CHAPTERS 00:00 Introduction: Meet the Mind Behind Humata Health 04:55 A Decade in Prior Auth: The Problem That Sparked Humata 07:24 Why Prior Authorization Needs Both Policy and Technology 10:24 The Shared Pain: Bridging Providers and Payers 15:14 How It Actually Works: Inside Modern Prior Authorization Tech 22:02 The Hardest Part: Extracting Data from EMRs 26:49 How Automation Replaces Manual Follow-Ups 28:34 After Approval: The Risk of Prior Auth Expiration 30:26 Why Humata Wins: Focus, Speed, and a Head Start 35:38 Will AI Replace Prior Auth Jobs? 39:25 Faster Decisions, Better Care: The Impact of CMS 0057 41:52 Conclusion: Prior Auth Is Solvable—But You Have to Start Now RESOURCES Today Sponsors: Jane | One Month Grace Period Promo Code: PRACTICESOLUTIONS1MO Learn More About Humata Health: Visit humatahealth.com 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. Get full access to The Claim Game at jeremyzug.substack.com/subscribe

    46 min
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out of 5
2 Ratings

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
    46
  • Rating
    Clean
  • Copyright
    © Jeremy Zug
  • Show Website
    The Claim Game

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